340306403-1-10-2023-03-CC-ATIY-CMXT5H-20230110132533

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 340306403
Report Date: 01/10/2023
Date Signed: 01/10/2023 01:25:43 PM

Document Has Been Signed on 01/10/2023 01:25 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME:	WASHINGTON CHILDREN'S CENTER		FACILITY NUMBER:	340306403
ADMINISTRATOR:	WILL ANDERSON		FACILITY TYPE:	850
ADDRESS:	530 18TH STREET		TELEPHONE:	(916) 264-4365
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95814
CAPACITY: 24	TOTAL ENROLLED CHILDREN: 24	CENSUS: 12	DATE:	01/10/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	Will Anderson		TIME COMPLETED:	01:45 PM

NARRATIVE

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On January 10, 2023, at approximately 11:30 AM, Licensing Program Analyst (LPA) Alize Tillery met with Director Will Anderson for the purpose of an unannounced required 1 year annual inspection. Upon arrival, LPA observed 12 preschool children supervised by 3 staff. The facility hours of operation are Monday through Friday from 8:30 AM to 3:00 PM. The facility does not offer transportation services.

LPA toured all activity and classroom spaces (Room P), restrooms and outdoor play area. LPA observed the following documents are posted: License, Emergency Disaster Plan, Personal Rights, Parents' Rights Poster and daily schedule. Cleaning disinfectants and hazardous items are appropriately stored and inaccessible to children. Director stated there are no medications, poisons or firearms on the premises. Furniture and equipment are in good condition, and toileting facilities are in safe, sanitary and operating condition, and the floors appeared to be clean throughout the facility. LPA observed a functional carbon monoxide detector, smoke detector and fire extinguisher. LPA discussed COVID19 guidelines. Director stated that the program has completed the required Lead Testing.

The program provides breakfast, lunch and pm snack. LPA observed trash bins with tight fitted lids. Drinking water is readily available to children both indoors and outdoors. Director stated that they use filtered water gallons and paper cups. LPA observed the facility’s sign in and out system. Facility has record of conducting fire drills at least every six months; last fire drill was conducted on 09/23/2022. Playground equipment and surfaces are free of loose or sharp parts. There are sufficient equipment and toys. There are shaded areas supplied by trees and bark under the play equipment for cushioning.

Report continues on 809-C.

SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Alize Tillery
LICENSING EVALUATOR SIGNATURE:	DATE: 01/10/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2023

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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Document Has Been Signed on 01/10/2023 01:25 PM - It Cannot Be Edited

Created By: Alize Tillery On 01/10/2023 at 01:02 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: WASHINGTON CHILDREN'S CENTER	FACILITY NUMBER: 340306403
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/10/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.7995(a)(1)

General Provisions and Definitions

(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview, record review, the licensee did not comply with the section cited above in that staff did not have immunization records on file, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 01/31/2023
	Plan of Correction
1 2 3 4	Director will submit proof of staff immunizations

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview, record review, the licensee did not comply with the section cited above in that staff #3 did not have a mandated reporter certificate, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 01/31/2023
	Plan of Correction
1 2 3 4	Director will submit proof of staff mandated reporter training certificate.

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME:

Seychelle De Luca

LICENSING EVALUATOR NAME:

Alize Tillery

LICENSING EVALUATOR SIGNATURE:

DATE: 01/10/2023

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2023

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: WASHINGTON CHILDREN'S CENTER	FACILITY NUMBER: 340306403
	VISIT DATE: 01/10/2023

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3 staff and 5 children records were reviewed. Staff files were observed to be missing immunization records and one staff member was missing the mandated reporter training certificate. Staff files should include: Education Verification, LIC 501 Personnel Record, LIC 503 Health Screenings, LIC 508 Criminal Record Statements, LIC 9052 Employee Rights, Immunizations (Tdap, MMR, Influenza) and current Mandated Reporter training certificates. At least one staff member present today has a current Pediatric CPR and First Aid certification that expires on 1/19/2023.

Children Files were also observed to be complete and included: Admission Agreements, Physician and Parent Health History Reports, Emergency Cards, Consent for Medical Treatment forms, Personal and Parent Rights Forms, and immunizations. LPA observed a current Children’s Roster. LPA reminded Licensees that 100% supervision is required at all times. LPA reviewed the Department's inspection authority and discussed with designee any changes that may occur regarding the director or an employee acting in the director's absence must be reported to department within ten working days.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA is provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

Director was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Deficiencies are cited on the following 809D page.

A notice of site visit was given and must remain posted for 30 days. An exit interview was conducted and the report was reviewed with the Director, Will Anderson.

SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Alize Tillery
LICENSING EVALUATOR SIGNATURE:	DATE: 01/10/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2023

LIC809 (FAS) - (06/04)

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