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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 340316216
Report Date: 11/21/2024
Date Signed: 11/21/2024 05:07:37 PM

Document Has Been Signed on 11/21/2024 05:07 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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:SUNRISE KIDS CLUB - ANTELOPE MEADOWSFACILITY NUMBER:
340316216
ADMINISTRATOR/
DIRECTOR:		FABELA ELICIAFACILITY TYPE:
840
ADDRESS:8343 PALMERSON DRIVETELEPHONE:
(916) 725-0794
CITY:ANTELOPESTATE: CAZIP CODE:
95843
CAPACITY: 90TOTAL ENROLLED CHILDREN: 90CENSUS: 0DATE:
11/21/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Ailin PearceTIME VISIT/
INSPECTION COMPLETED:
05:15 PM
NARRATIVE
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On November 21, 2024, Licensing Program Analyst (LPA) Loraine Perez arrived at  Sunrise Antelope Meadows and met with Site Director, Ailin Pearce for the purpose of an unannounced, required - 1 year inspection. The program is being operated in rooms 1, 2, & 3. There were no children present during the inspection. At 2:45 pm, 67 children were present and supervised by seven staff. Facility hours of operation are from 7:00 a.m. - 8:25 a.m. and 1:25 p.m.- 6:00 p.m., Tuesday thru Friday and  7:00 a.m. - 8:25 a.m. and 1:45p.m. - 6:00 p.m. on Monday.

Individuals that were present during the inspection today have fingerprint clearances. Site 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.
 
LPA toured all activity and classroom spaces, restrooms, food service, and outdoor play areas. Medications are properly stored and inaccessible to children. Site Director stated that there are no poisons at the facility. Toxic and hazardous items are inaccessible to children. Furniture and equipment are in good condition, free of hazards. The facility utilizes the playground on the school campus. Toileting facilities are in safe, sanitary, and operating condition. Facility provides PM snack. Menus were posted in the facility. The food preparation space is free of litter and all food was protected against contamination. Storage containers with solid waste have tight-fitting lids.

LPA observed the licensed school age program was found to comingle with another program, ELOP, not licenced by Dept of Social Services.

Report continues on LIC809C
SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Loraine Perez
LICENSING EVALUATOR SIGNATURE: DATE: 11/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/21/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: SUNRISE KIDS CLUB - ANTELOPE MEADOWS
FACILITY NUMBER: 340316216
VISIT DATE: 11/21/2024
NARRATIVE
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Drinking water was readily available to children via labeled bottles and the facility provides cups and has drinking fountains in each classroom and outdoors. The sign in and sign out is conducted electronically on the Procare application. There are no firearms or bodies of water on the premises. LPA observed a functional combination carbon monoxide and smoke detector.
Seven staff files were reviewed. Four staff files are missing health screenings. At least one staff member present today has current Pediatric CPR and First Aid certification. LPA observed five immunization records are missing from seven staff files reviewed. LPA observed documentation of the educational background, training, and/or experience for staff present during today's inspection.  Four staff do not meet teacher qualifications.
 
Children's records were reviewed. Ten children files are missing consent for emergency medical treatment. Site director printed forms for families to sign as children were picked up during today's inspection. Each child's file contained an emergency card and enrollment agreement. 
Medications were observed at the facility. Incidental Medical Services – IMS was discussed. 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 annual fees which are up to date. LPA informed the Director of the recent regional office relocation and provided updated personal and parent's rights forms and postings.
Facility Representative was informed of the www.mychildcareplan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

Report continued on 809-C
SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Loraine Perez
LICENSING EVALUATOR SIGNATURE:

DATE: 11/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2024
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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: SUNRISE KIDS CLUB - ANTELOPE MEADOWS
FACILITY NUMBER: 340316216
VISIT DATE: 11/21/2024
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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.
In the areas that were evaluated, deficiencies were cited on 809-D. Exit interview conducted and report was reviewed with Director, Ailin Pearcel. A notice of site visit was given and must remain posted for 30 days.

Title 22 Deficiencies have been cited on the attached LIC 809-D. LPA Loraine Perez informed Site Director Ailin Pearce that this report dated November 21, 2024, document(s) 2 Type A citation which shall be posted for 30 consecutive days as there is an immediate risk to the health, safety, or personal rights of children in care.  Also, LPA Loraine Perez informed the Site Director to provide a copy of this licensing report dated November 21, 2024, that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.  Appeal Rights given.
SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Loraine Perez
LICENSING EVALUATOR SIGNATURE:

DATE: 11/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2024
LIC809 (FAS) - (06/04)
Page: 3 of 6
Document Has Been Signed on 11/21/2024 05:07 PM - It Cannot Be Edited


Created By: Loraine Perez On 11/21/2024 at 03:55 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
, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: SUNRISE KIDS CLUB - ANTELOPE MEADOWS
FACILITY NUMBER: 340316216

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/21/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
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
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3
4
Based on record review, the site director did not comply with the section cited above in five out of seven staff files reviewed which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 11/22/2024
Plan of Correction
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Site director stated they have requested from staff today to submit proof of measles, pertussis, and influenza.
Type A
Section Cited
CCR
101538.3b

In combination programs, indoor activity space provided for school-age child care center children shall be physically separated from space provided for infant care and child care center children.
This requirement is not met as evidenced by:
Deficient Practice Statement
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2
3
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Based on observation and record review, the site director did not comply with the section cited above, the licensed school age program was found to comingle with another program, ELOP, not licenced by Dept of Social Services. which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 11/22/2024
Plan of Correction
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Site director stated they will discuss a plan of corretion to share space but maintain separate programs.
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:Amanda Blesi
LICENSING EVALUATOR NAME:Loraine Perez
LICENSING EVALUATOR SIGNATURE:
DATE: 11/21/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/21/2024


LIC809 (FAS) - (06/04)
Page: 4 of 6
Document Has Been Signed on 11/21/2024 05:07 PM - It Cannot Be Edited


Created By: Loraine Perez On 11/21/2024 at 03:55 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
, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: SUNRISE KIDS CLUB - ANTELOPE MEADOWS
FACILITY NUMBER: 340316216

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/21/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101216(g)(2)
Personnel Requirements
(2) Each person specified in (g) above shall have a health-screening report signed by the person performing the screening. This report shall indicate the following:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the site director did not comply with the section cited above in five staff do not have a health screening report on file which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/20/2024
Plan of Correction
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Site director stated they will email LPA at loraine.perez@dss.ca.gov with dates of appointments staff have sceduled to obtain the health screening report. LPA will return for a Plan of Correction visit.
Type B
Section Cited
CCR
101216.1(b)(1)
Teacher Qualifications and Duties
(1) A teacher shall have completed, with passing grades, at least six postsecondary semester or equivalent quarter units of the education requirement specified in (c)(1) below; or shall have obtained a Child Development Assistant Permit issued by the California Commission on Teacher Credentialing.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the site director did not comply with the section cited above four staff do not meet teacher qualifications which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/20/2024
Plan of Correction
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Site director stated they will collect class schedules for staff that have regisered for course work to meet teacher qualification.
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:Amanda Blesi
LICENSING EVALUATOR NAME:Loraine Perez
LICENSING EVALUATOR SIGNATURE:
DATE: 11/21/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/21/2024


LIC809 (FAS) - (06/04)
Page: 5 of 6
Document Has Been Signed on 11/21/2024 05:07 PM - It Cannot Be Edited


Created By: Loraine Perez On 11/21/2024 at 03:55 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
, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: SUNRISE KIDS CLUB - ANTELOPE MEADOWS
FACILITY NUMBER: 340316216

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/21/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101221(b)(8)(C)
Child's Records
(b) Each record shall contain information including, but not limited to, the following: (8) Medical assessment, including ambulatory status as specified in Section 101220, and the following health information: (C) A signed consent form for emergency medical treatment unless the child's authorized
representative has signed the statement specified in Section 101220(f).

This requirement is not met as evidenced by:
Deficient Practice Statement
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4
Based on record review, the site director did not comply with the section cited above, consent for emergency medical treatment form was not on file for each childrens file reviewed, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/20/2024
Plan of Correction
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Site director stated it will be requested from each family to sign forms to have on file for each child. It was observed the Site director began the process of collecting signatures on the day of inspection. LPA will return for plan of corrections inspection.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Amanda Blesi
LICENSING EVALUATOR NAME:Loraine Perez
LICENSING EVALUATOR SIGNATURE:
DATE: 11/21/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/21/2024


LIC809 (FAS) - (06/04)
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