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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 340316146
Report Date: 05/25/2023
Date Signed: 05/25/2023 09:58:50 AM

Document Has Been Signed on 05/25/2023 09:58 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:ETHEL I. BAKER PRESCHOOLFACILITY NUMBER:
340316146
ADMINISTRATOR:MILLER, MELISSAFACILITY TYPE:
850
ADDRESS:5717 LAURINE WAY, ROOM 29TELEPHONE:
(916) 395-4562
CITY:SACRAMENTOSTATE: CAZIP CODE:
95824
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 19DATE:
05/25/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Melissa MillerTIME COMPLETED:
10:15 AM
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On Thursday, May 25, 2023, Licensing Program Analyst (LPA) Amanda Sutter met Lead Teacher Melissa Miller for the purpose of an unannounced required annual inspection. LPA observed 19 children supervised by three staff. All individuals subject to criminal background review have obtained a criminal record clearance. The facility hours of operation are Monday through Thursday from 8:00 AM to 2:30 PM, and Friday from 8:00 AM to 11:45 PM.

LPA toured classroom space, restrooms, and outdoor play area. LPA observed the following documents are posted: License, Parents' Rights Poster, Personal Rights form, Seat Belt Law, Shared Outdoor Space Waiver, Menu, and Emergency Disaster Plan. Cleaning disinfectants and hazardous items are appropriately stored and inaccessible to children. Director stated there are no poisons or firearms on the premises. LPA observed medication to be stored appropriately and out of reach of children. Furniture and equipment are in good condition, and toileting facilities are in safe, sanitary, and operating condition. The provides breakfast, lunch, and a snack.

LPA observed trash bins with tight fitted lids. LPA observed the facility’s paper sign in and out system. Facility has record of conducting fire drills at least every six months. The last fire drill was conducted on April 21, 2023. Bark is present under playground equipment to provide sufficient cushioning. LPA discussed the condition of playground equipment with the site supervisor. There are sufficient equipment and toys, and shaded areas are supplied by shade clothes. Drinking water is readily available to children both indoors and outdoors. Director stated that outdoors, children use drinking fountains. Indoors, children are provided water through use of a water pitcher and cups.

Three staff and five children's records were reviewed. Both children’s files and staff files were observed to be complete. There is at least one staff member present with a current CPR certificate.PAGE 1. REPORT CONTINUES ON LIC809-C

SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Amanda Sutter
LICENSING EVALUATOR SIGNATURE: DATE: 05/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/25/2023
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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME: ETHEL I. BAKER PRESCHOOL
FACILITY NUMBER: 340316146
VISIT DATE: 05/25/2023
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LPA discussed the safe sleep regulations with director and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPAS also informed director of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Incidental Medical Service (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 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

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.

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.

During today’s inspection, no deficiencies were observed. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with Site Supervisor Melissa Miller. Appeal rights were provided.

SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Amanda Sutter
LICENSING EVALUATOR SIGNATURE:

DATE: 05/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/25/2023
LIC809 (FAS) - (06/04)
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