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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313606470
Report Date: 06/04/2024
Date Signed: 06/04/2024 09:32:53 AM

Document Has Been Signed on 06/04/2024 09:32 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:CHILDTIME CHILDREN'S CENTERFACILITY NUMBER:
313606470
ADMINISTRATOR/
DIRECTOR:		SUSAN PERKINSFACILITY TYPE:
830
ADDRESS:8747 SIERRA COLLEGE BLVD.TELEPHONE:
(916) 791-2530
CITY:ROSEVILLESTATE: CAZIP CODE:
95661
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 12DATE:
06/04/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:00 AM
MET WITH:Susan PerkinsTIME VISIT/
INSPECTION COMPLETED:
09:30 AM
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Licensing Program Analyst (LPA) Jeremey McClain met with facility representative Susan Perkins for an unannounced Case Management Inspection regarding an Unusual Incident Report.

LPA observed 12 infants supervised by four staff members.

It was reported that on 05/28/2024, a child swallowed a stapler while in care. The child was taken for x-rays by their parents, where it was determined that the staple had reached their stomach but did not have prongs to it. LPA observed the infant classroom, reviewed children’s files, and interviewed staff during today’s inspection. LPA determined that the incident was not due to a lack of supervision or an unclean play space.

An exit interview was conducted and a Notice of Site Visit was provided that should remain posted for 30 days.
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Jeremey McClain
LICENSING EVALUATOR SIGNATURE: DATE: 06/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/04/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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