340314892-4-26-2023-03-CC-MGON-CR9THX-20230426144529

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 340314892
Report Date: 04/26/2023
Date Signed: 04/26/2023 02:45:46 PM

Document Has Been Signed on 04/26/2023 02:45 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
RIVER CITY (SACTO)CC, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME:	GENERAL DAVIE, JR. PRIMARY CENTER		FACILITY NUMBER:	340314892
ADMINISTRATOR:	APPLEBY, SIERRA		FACILITY TYPE:	850
ADDRESS:	1500 DOM WAY		TELEPHONE:	(916) 971-7375
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95864
CAPACITY: 296	TOTAL ENROLLED CHILDREN: 296	CENSUS: 152	DATE:	04/26/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:45 AM
MET WITH:	Ash Gully		TIME COMPLETED:	03:00 PM

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On Wednesday April 26th, 2023, Licensing Program Analyst (LPA) Mandie Goodwin and Application Specialist (AS) Mai Lor met with designated facility representative Ash Gully, for the purpose of an unannounced 1 year required inspection. Facility operates licensed preschools from ages 2- entry into first grade in room 1, 2, 14, 15, 16, 19, and 21. Ages 3-5 are in room 18, and a toddler option is in rooms 4 & 5. Facility hours of operation are 7:00am - 4:30. Facility provides breakfast and lunch and provides a nap time. LPA toured the facility, at which time a census of 152 children supervised by 22 staff was observed. Staff criminal record clearances are maintained by the department of education.

A health and safety inspection was conducted in all classrooms, restrooms, food service areas, and outdoor play areas. LPA observed the following documents are posted: License, Emergency Disaster Plan, Personal Rights, Parents' Rights Poster, required publications, menus, and daily schedules. Cleaning disinfectants and hazardous items are appropriately stored and inaccessible to children. Medications are stored out of reach and inaccessible to children. Furniture and equipment are in good condition, and toileting facilities are in sanitary, and operating condition. Bins for solid waste have tight fitting lids. The floors appeared clean throughout the facility. LPA observed smoke and carbon monoxide detectors. LPA observed nap equipment to be stored appropriately. LPA observed that 15 minute sleep checks are conducted in the toddler classroom for children under 2 years old.

Children have access to water indoors and outdoors using cups. Playground equipment and surfaces are free of loose or sharp parts, and facility has a waivers on file for shared space. LPA observed sufficient cushioning and shade. Outdoor shade is provided by trees. There are no firearms or bodies of water on the premises. Representative stated there are no poisons on the premises.

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SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Mandie Goodwin
LICENSING EVALUATOR SIGNATURE:	DATE: 04/26/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/26/2023

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVER CITY (SACTO)CC, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: GENERAL DAVIE, JR. PRIMARY CENTER	FACILITY NUMBER: 340314892
	VISIT DATE: 04/26/2023

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LPA reviewed staff files. At least one staff member present today has current Pediatric CPR and First Aid certification. LPA observed immunization records and documentation of the educational background, training, and/or experience. Upon review, all staff members had current mandated reporter training. LPA advised AB 1207 Mandated Reporter training must be renewed every two years and can be renewed at www.mandatedreporterca.com. Facility has record of conducting fire drills at least every six months. Per record the last fire drill was conducted in April 2023. Children are signed in and out of the facility using a digital application and paper.

A sample of 7 children's records were reviewed. Each child's file contained an emergency card, consent for emergency medical treatment, health history, a record of immunization’s and notifications of children’s and parent’s rights. LPA provided the Community Care Licensing’s website www.ccld.ca.gov, so the representative can obtain updated licensing information, new regulations and access forms. LPA advised representative of their responsibility to stay current in regards to new regulations.

Facility representative 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.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.The following information regarding ADA was 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

LPA discussed Assembly Bill 2370, which will require licensed Child Care facilities to test their water for excessive amounts of lead. Testing will be required beginning January 1st, 2020 to January 1st, 2023 and must be conducted every five years from initial testing.

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SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Mandie Goodwin
LICENSING EVALUATOR SIGNATURE:	DATE: 04/26/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/26/2023

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
RIVER CITY (SACTO)CC, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: GENERAL DAVIE, JR. PRIMARY CENTER	FACILITY NUMBER: 340314892
	VISIT DATE: 04/26/2023

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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

NO TITLE 22 DEFICIENCIES CITED TODAY. Exit interview was conducted and report was reviewed with the Facility Representative Ash Gully. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Mandie Goodwin
LICENSING EVALUATOR SIGNATURE:	DATE: 04/26/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/26/2023

LIC809 (FAS) - (06/04)

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