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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 340319878
Report Date: 02/26/2025
Date Signed: 02/26/2025 10:46:16 AM

Document Has Been Signed on 02/26/2025 10:46 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:B.J. JORDAN CHILD CARE - JEFFERSONFACILITY NUMBER:
340319878
ADMINISTRATOR/
DIRECTOR:		HECTOR RAMOSFACILITY TYPE:
850
ADDRESS:2001 PEBBLEWOOD DRIVETELEPHONE:
(916) 920-8188
CITY:SACRAMENTOSTATE: CAZIP CODE:
95833
CAPACITY: 25TOTAL ENROLLED CHILDREN: 25CENSUS: 10DATE:
02/26/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Tiffany McPhersonTIME VISIT/
INSPECTION COMPLETED:
11:00 AM
NARRATIVE
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On Wednesday 26 February, 2025 at approximately 9:30 AM, Licensing Program Analyst (LPA) Fabian Schwartz met with Assistant Center's Manager Tiffany McPherson for a case management inspection. Upon arrival, there were 10 preschool children supervised by 5 staff. During visit, Center's Manager Tarra Kleiser arrived to center to assist with inspection.

An Unusual Incident was called into the office on 18 February 2025. LPA interviewed Assistant Center's Manager Tiffany McPherson regarding the incident. It was self-reported that on 18 February 2025, around 10:15 am 1 child was left in classroom while other children and staff transitioned to outside play area. Child was in classroom for less than 1 minute before staff immediately returned to classroom. Based on the self-reported unusual incident and an interview with the staff, a Type A deficiency was cited on LIC 809-D. The Department is issuing a Type A citation regarding the Lack of Supervision violation and a Civil Penalty of $500 is being assessed during today’s visit.

Title 22 deficiencies are cited on the subsequent pages of this report. Director acknowledges, that FOR TYPE A DEFICIENCIES ONLY upon receipt, licensee shall post LIC 809-D with Type A deficiencies for 30 days and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. LIC 9224 must be signed by parents/guardians and kept with the children's forms as a receipt whenever any Type A documents are provided by the Licensee. LIC 9224 and Appeal Rights were provided. Director's signature on this report acknowledges receipt of these rights.

This report was reviewed with the Assistant Center's Manager and an exit interview was conducted. A Notice of Site Visit was provided and shall remain posted for a period of 30 days.

SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Fabian Schwartz
LICENSING EVALUATOR SIGNATURE: DATE: 02/26/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/26/2025
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 02/26/2025 10:46 AM - It Cannot Be Edited


Created By: Fabian Schwartz On 02/26/2025 at 10:24 AM
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: B.J. JORDAN CHILD CARE - JEFFERSON
FACILITY NUMBER: 340319878

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/26/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/27/2025
Section Cited
CCR
101229(a)(1)

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101229 Responsibility for Providing Care and Supervision: (a)The licensee shall provide care and supervision as necessary to meet the children's needs (1)No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). This requirement was not met as evidenced by:
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Staff was retrained with supervision requirements and will implement more thorough classroom transitions with supervisors.
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Based on observations, interviews, and record review, the licensee did not comply with the section cited above by having a self-reported incident on 18 February 25 where a child was left without supervision in a classroom for less than 1 minute, which poses an immediate health, safety or personal rights risk to persons in care.
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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:Fabian Schwartz
LICENSING EVALUATOR SIGNATURE:
DATE: 02/26/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/26/2025


LIC809 (FAS) - (06/04)
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