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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 340321448
Report Date: 10/22/2024
Date Signed: 10/22/2024 03:46:36 PM

Document Has Been Signed on 10/22/2024 03:46 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:ROBLA PRESCHOOLFACILITY NUMBER:
340321448
ADMINISTRATOR/
DIRECTOR:
FABIOLA SALCEDAFACILITY TYPE:
850
ADDRESS:4351 PINELL STREETTELEPHONE:
(916) 927-0136
CITY:SACRAMENTOSTATE: CAZIP CODE:
95838
CAPACITY: 198TOTAL ENROLLED CHILDREN: 198CENSUS: 63DATE:
10/22/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:15 AM
MET WITH:Fabiola Salceda TIME VISIT/
INSPECTION COMPLETED:
04:15 PM
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At 9:15 a.m. on Tuesday, October 22, 2024, Licensing Program Analyst (LPA) Pa Dao Vang met with Director/Licensee, Fabiola Salceda, and Nichol Sullivan, for the purpose of an unannounced, annual required inspection. LPA observed a census of 63 children supervised by 16 staff. Facility hours of operation for the part day are from 8:00 a.m. to 11:00 a.m. and a full day program is 7:30 to 4:30 p.m. on Mondays thru Fridays. Center provides breakfast, lunch, and p.m. snack for the children in the full day program. They also provide breakfast and lunch for the part time program. The facility offers transportation services to Room #11 children.

Director/Licensee 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 conducted a health and safety inspection of the classrooms #10, #11, #12, and #13 with the restrooms. LPA also tour the licensed rooms #6, #7, and #9. Director/Licensee stated the rooms are licensed but are not enrolling children due to the construction. These rooms are used as the office, storage, and staff’s breaks. LPA observed the following documents are posted: License, Emergency Disaster Plan, Personal Rights, Parents' Rights Poster, Earthquake Preparedness, Child Passenger Restraint Poster, Parent’s Notification, LIC613A Person Rights, Daily Activity Schedule, and menus. Cleaning disinfectants, medications and hazardous items are appropriately stored and inaccessible to children. Furniture and equipment are in good condition. Drinking water is accessible via water filter container and cups in each classroom and playground area.

Continue report on LIC809-C...

SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Dao Vang
LICENSING EVALUATOR SIGNATURE: DATE: 10/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/22/2024
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: ROBLA PRESCHOOL
FACILITY NUMBER: 340321448
VISIT DATE: 10/22/2024
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LPA observed trash bins with tight fitted lids. Toileting facilities are in safe, sanitary condition. The floors appeared to be clean throughout the facility. Director/Licensee stated that there is no smoking, no firearms nor poisons on the premises. LPAs observed the facility’s sign in and out system. Facility has record of conducting fire drills at least every six months; last fire drill was conducted on 10/10/2024.

Facility provides Incidental Medical Services. 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 conducted a health and safety inspection of the outdoor space. The play structure have proper cushioning under it. LPA observed several nails sticking outwards from the wooden boarders of the wood chip/play structure area. Director/Licensee immediately instructed an adult to hammer the nails during the inspection. Outdoor shade was provided by canopy, building, and a trees.



LPA reviewed staff and children's records. LPA observed current employee rights, and documentation of the educational background, training, and/or experience. There is at least 1 staff with current CRP/First Aid certification in the facility. LPA observed 6 out of 16 staff missing current immunization records in their personnel file.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

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 childcare 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). Director/Licensee stated the lead testing was completed in 2023 and will obtain a copy of the results. Director/Licensee will also email a copy to LPA. Continue report on LIC809-C...

SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Dao Vang
LICENSING EVALUATOR SIGNATURE:

DATE: 10/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 10/22/2024 03:46 PM - It Cannot Be Edited


Created By: Dao Vang On 10/22/2024 at 02:17 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: ROBLA PRESCHOOL

FACILITY NUMBER: 340321448

DEFICIENCY INFORMATION FOR THIS PAGE:

VISIT DATE: 10/22/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
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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Based on observation, interviews, record reviews, the licensee did not comply with the section cited above in 6 out of 16 staff missing immunization (MMR, Tdap, and/or flu) in their personnel file, which posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/22/2024
Plan of Correction
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Director/Licensee Fabiola Salceda and Nichol Sullivan will obtain the missing immunization from staff for their files. They will also email LPA Vang copies of the missing immunization by the Plan of Correction date to clear the citation.
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:Seychelle De Luca
LICENSING EVALUATOR NAME:Dao Vang
LICENSING EVALUATOR SIGNATURE:
DATE: 10/22/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/22/2024


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: ROBLA PRESCHOOL
FACILITY NUMBER: 340321448
VISIT DATE: 10/22/2024
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Facility Representative was informed of the 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.

A deficiency is being cited based on LPA’s observation, interviews conducted, and record reviews in accordance with the California Code of Regulations, Title 22, see LIC809-D page. An exit interview was conducted with Director/Licensee, Fabiola Salceda. A copy of the appeal rights and a notice of site visit were also provided to Director/Licensee. Notice of site visit shall remain posted for a period of 30 consecutive days.
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Dao Vang
LICENSING EVALUATOR SIGNATURE:

DATE: 10/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2024
LIC809 (FAS) - (06/04)
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