343601750-1-21-2025-03-CC-GSIH-DD5USP-20250121145039

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343601750
Report Date: 01/21/2025
Date Signed: 01/21/2025 02:50:51 PM

Document Has Been Signed on 01/21/2025 02:50 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:	CHARLES E. MACK PRESCHOOL		FACILITY NUMBER:	343601750
ADMINISTRATOR/ DIRECTOR:	COLLIER, ROBERTA		FACILITY TYPE:	850
ADDRESS:	4701 BROOKFIELD DRIVE		TELEPHONE:	(916) 422-1566
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95823
CAPACITY: 24	TOTAL ENROLLED CHILDREN: 24	CENSUS: 18	DATE:	01/21/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	12:45 PM
MET WITH:	Cheng Vang		TIME VISIT/ INSPECTION COMPLETED:	03:00 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst (LPA) Gagandeep Singh met with facility representative, Cheng Vang, for an annual inspection. Purpose of the inspection was explained. This facility operates at a school site from portable B1. All staff have criminal background clearance through school district. During inspection, there are 18 children in care with three staff members. Facility operates day care from Monday to Friday between 12:15 AM to 3:15 PM and from Monday to Thursday 8:00 AM to 11:30 PM. During today’s inspection, LPA inspected the day care classroom, bathroom and play yard. LPA observed the facility has smoke detector, carbon monoxide detector, multiple fully charged fire extinguishers, fire pull alarms and working telephone at the site. Facility has first aid supplies available in the classroom. All of the cleaning solutions, poisons and other chemicals that are dangerous to the children are stored inaccessible to the children. Facility has age appropriate furniture. Furniture is steady and in good repair. All toilets, hand washing facilities are in working condition with proper sanitation in place. The classroom has proper temperature and ventilation in place. Facility has drinking water available for children. All the materials and surface accessible to the children is clean and toxic free. All the food is stored in properly manner and has lid to avoid any contamination. Play yard is free of hazards. There is sufficient amount of wood chips under the play structures to prevent any fall injury. LPA observed that facility has license, waiver and all of the required documents posted and are visible for public. LPA reviewed staff records and observed that staff members have record of valid CPR training card on file. The facility has fire and emergency drill log and per log, last drill was conducted on January 15, 2025. LPA reviewed the random children records and observed the facility has all of the required documents in files. See next page for continuation ..........

SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Gagandeep Singh
LICENSING EVALUATOR SIGNATURE:	DATE: 01/21/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2025

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: CHARLES E. MACK PRESCHOOL	FACILITY NUMBER: 343601750
	VISIT DATE: 01/21/2025

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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.

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). LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP. LPA referred facility representative to the Department website for lead: Lead Toxicity Prevention and Water Testing Information

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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) 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/.

No deficiencies were cited during today's inspection. Copy of this report was reviewed and provided to the facility representative. Notice of site visit is posted and shall remain posted for next 30 days.

SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Gagandeep Singh
LICENSING EVALUATOR SIGNATURE:	DATE: 01/21/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2025

LIC809 (FAS) - (06/04)

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