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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343608842
Report Date: 09/23/2024
Date Signed: 12/17/2024 10:55:40 AM

Document Has Been Signed on 12/17/2024 10:55 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:SOMETHING EXTRA PRESCHOOL & CHILDCAREFACILITY NUMBER:
343608842
ADMINISTRATOR/
DIRECTOR:		THROCKMORTON, JAMIEFACILITY TYPE:
830
ADDRESS:7916 AZTEC DR.TELEPHONE:
(916) 348-0712
CITY:ANTELOPESTATE: CAZIP CODE:
95843
CAPACITY: 15TOTAL ENROLLED CHILDREN: 15CENSUS: 5DATE:
09/23/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:15 AM
MET WITH:Jamie ThrockmortonTIME VISIT/
INSPECTION COMPLETED:
03:00 PM
NARRATIVE
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This document is an amendment of the original report and reflects changes made through the appeal process.

Licensing Program Analyst (LPA) Loraine Perez met with Facility Representative, Jamie Throckmorton, for an unannounced annual inspection. LPA observed a census five infants being supervised by two staff in one classroom. Facility Representative was reminded never to exceed the conditions, limitations and capacity specified on the license. All individuals subject to criminal record review have obtained clearance. Facility hours of operation are Monday through Friday, 06:30 AM to 06:00 PM.



LPA inspected all activity and classroom spaces, restrooms, food service, and outdoor play areas. Hazardous items were inaccessible to children. LPA observed pitchers of formula are used to fill bottles for infants throughout their day in care. Staff stated the parents prepare the formula and the pitches are kept refrigerated and labeled with the date it was prepared and the child’s name. The staff then fill an infant’s individual bottle when needed this meets Title 22 regulations. The floors appeared clean throughout the facility. Furniture and equipment were in safe, operable condition. Outdoor activity space is shared with the preschool group, but not at the same time. LPA observed the equipment was in good repair and free of loose or sharp parts. LPA observed adequate cushioning in areas underneath climbing equipment and adequate shade provided. Toileting facilities were in safe, sanitary, and operating condition. Food preparation space was hygienic, and all food protected against contamination. Menus were posted for AM/PM snack and lunch, which is provided by the facility. Uncontaminated drinking water was readily available to children both indoors and outdoors. Trash bins have tight-fitting lids. LPA observed there are no medications being stored at the time of this inspections. An ample amount of first aid supplies were available. LPA observed a functional carbon monoxide detector and a fully charged 2A10BC fire extinguisher within the facility. Facility uses paper sign in/out system. LPA observed swimming pools separated from the center premises by a ten foot high fence and gate that is locked. The Licensee stated the pools and its surrounding fencing and gate are not under the control of the center. This facility is not in control of the pool fencing.

Report continues on LIC809C
SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Loraine Perez
LICENSING EVALUATOR SIGNATURE: DATE: 09/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/23/2024
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 5
Document Has Been Signed on 09/23/2024 02:42 PM - It Cannot Be Edited


Created By: Loraine Perez On 09/23/2024 at 01:05 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: SOMETHING EXTRA PRESCHOOL & CHILDCARE
FACILITY NUMBER: 343608842

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/23/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101438.2(b)
Outdoor Activity Space For Infants
(b) Outdoor activity space shall be physically separate from space used by children in the child care center and school-age child care center components.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interview, the licensee did not comply with the section cited above, the infants do not have exclusive use of the play yard, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/23/2024
Plan of Correction
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Licensee stated she will submit a request for a waiver for use of a shared play yard.
Type B
Section Cited
CCR
101216(g)(1)
Personnel Requirements
(1) Except as specified in (3) below, good physical health shall be verified by a health screening, including a test for tuberculosis, performed by or under the supervision of a physician not more than one year prior to or seven days after employment or licensure.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview, record review, the licensee did not comply with the section cited above, two persons do not have a health screening on file which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/23/2024
Plan of Correction
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Licensee stated she will email health screening forms by POC date.
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: 09/23/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/23/2024


LIC809 (FAS) - (06/04)
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Document is an Amendment of Original Document on 12/11/2024 04:37 PM


Created By: Loraine Perez On 09/23/2024 at 01:05 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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: SOMETHING EXTRA PRESCHOOL & CHILDCARE
FACILITY NUMBER: 343608842

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/23/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Deficiency Dismissed
Type B
Section Cited
CCR
101427(j)
Infant Care Food Service
(j) Bottles, dishes and containers of food brought by the infant's authorized representative shall be labeled with the infant's name and the current date.

This requirement is not met as evidenced by:
Deficient Practice Statement
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This citation has been dismissed through the appeals process.
POC Due Date: 10/23/2024
Plan of Correction
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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: 09/23/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/23/2024


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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: SOMETHING EXTRA PRESCHOOL & CHILDCARE
FACILITY NUMBER: 343608842
VISIT DATE: 09/23/2024
NARRATIVE
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LPA observed a current Needs and Services plan in each infant's file. LPA observed that all cribs were free of loose articles or objects and there was one crib or mat for each child in care with a tight fitted sheet. Staff stated that the bedding is changed daily. Infant diaper changing area is clean and there is a one-inch-thick mat for the changing table with a vinyl surface. Toys are of age-appropriate size, with no small parts for the safety of the infants. LPA observed labeled food and milk for infants, stored at safe temperatures. LPA observed staff documentation of feedings and diaper changes.

LPA reviewed facility records including child's records, personnel records, administrative records, and documents to be posted. LPA reviewed a sample of children’s files and observed that each child's file contained the required licensing documentation. LPA reviewed records for all staff. At least one staff member present today has current Pediatric CPR and First Aid certification expiring 10/2025. All staff currently employed with the facility have: a criminal record clearance, immunization records, current AB1207 Mandated Reporter Training, and documentation of their educational background, training, and/or experience. Record review revealed two staff did not have health screenings at the time of inspection. LPA observed a children's roster and fire drill log within the facility. LPA observed all required licensing documents were posted and visible to authorized representatives.

LPA discussed the safe sleep regulations with licensee facility representative and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA 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.
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.

Report continues on LIC809C
SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Loraine Perez
LICENSING EVALUATOR SIGNATURE:

DATE: 09/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2024
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: SOMETHING EXTRA PRESCHOOL & CHILDCARE
FACILITY NUMBER: 343608842
VISIT DATE: 09/23/2024
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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). LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP. CCC COMPLETED TESTING AND NO LEAD EXCEEDANCES. 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/.
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.
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.

In the areas that were evaluated, deficiencies were observed at the time of the inspections and cited on LIC 809D. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the facility representative Jamie Throckmorton.
SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Loraine Perez
LICENSING EVALUATOR SIGNATURE:

DATE: 09/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2024
LIC809 (FAS) - (06/04)
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