340321380-1-16-2025-03-CC-ASUR-DCYPHY-20250116102042

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 340321380
Report Date: 01/16/2025
Date Signed: 01/16/2025 10:20:56 AM

Document Has Been Signed on 01/16/2025 10:20 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:	PETER BURNETT PRESCHOOL		FACILITY NUMBER:	340321380
ADMINISTRATOR/ DIRECTOR:	GULALAI SHETAB		FACILITY TYPE:	850
ADDRESS:	6032 36TH AVE. RM.#3		TELEPHONE:	(916) 277-6522
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95824
CAPACITY: 24	TOTAL ENROLLED CHILDREN: 24	CENSUS: 13	DATE:	01/16/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	08:30 AM
MET WITH:	Gulalai Shetab		TIME VISIT/ INSPECTION COMPLETED:	10:45 AM

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On Thursday, January 16, 2025, Licensing Program Analysts (LPAs) Amanda Sutter and Payenda Seddiqi met with Lead Teacher Gulalai Shetab for the purpose of an unannounced required annual inspection. Upon arrival, LPAs observed 13 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.

LPAs toured classroom space and outdoor play area. LPAs observed the following documents are posted: License, Parents' Rights Poster, Child Personal Rights, Seat Belt Law, Menu, Daily Schedule, Shared Outdoor Space Waiver, Earthquake Preparedness Checklist, and Emergency Disaster Plan. LPAS observed a functional carbon monoxide detector and full 2A10BC fire extinguisher. Cleaning disinfectants and hazardous items are appropriately stored and inaccessible to children. Director stated there are no poisons or firearms on the premises. Furniture and equipment are in good condition, and toileting facilities are in safe, sanitary, and operating condition. The provides breakfast, lunch, and a snack.

LPAS observed trash bins with tight fitted lids. The facility uses an electronic sign in and out system. Facility has record of conducting fire drills at least every six months. The last fire drill was conducted on December 17, 2024. Playground equipment and surfaces are free of loose or sharp parts, and bark is present under the equipment to provide sufficient cushioning. There is sufficient equipment and toys, and shaded areas are supplied by building awning. Drinking water is readily available to children both indoors and outdoors. LPAS observed drinking fountains inside and outside the classroom, and director stated that the facility also uses filtered water pitchers with water cups.

Three staff and four 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: 01/16/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2025

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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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: PETER BURNETT PRESCHOOL	FACILITY NUMBER: 340321380
	VISIT DATE: 01/16/2025

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Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test.

For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP).

LPAS verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

LPAS discussed the safe sleep regulations with facility representative 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 facility representative 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.

This facility provides Incidental Medical Services – IMS. LPAS reviewed storage of “medication and equipment/supplies, and reviewed children’s, personnel, and administrative records.

For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care- centers/.

PAGE 2. REPORT CONTINUES ON LIC809-C

SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Amanda Sutter
LICENSING EVALUATOR SIGNATURE:	DATE: 01/16/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2025

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: PETER BURNETT PRESCHOOL	FACILITY NUMBER: 340321380
	VISIT DATE: 01/16/2025

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Facility representative was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Facility representative was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

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 Director Gulalai Shetab. Appeal rights were provided.

SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Amanda Sutter
LICENSING EVALUATOR SIGNATURE:	DATE: 01/16/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2025

LIC809 (FAS) - (06/04)

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