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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343609927
Report Date: 05/13/2024
Date Signed: 05/15/2024 09:51:54 AM

Document Has Been Signed on 05/15/2024 09:51 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:HERMAN LEIMBACH ELEMENTARY SCHOOLFACILITY NUMBER:
343609927
ADMINISTRATOR/
DIRECTOR:		CORDOVA, ABELARDOFACILITY TYPE:
850
ADDRESS:8101 GRANDSTAFF DR.TELEPHONE:
(916) 689-2120
CITY:SACRAMENTOSTATE: CAZIP CODE:
95823
CAPACITY: 48TOTAL ENROLLED CHILDREN: 48CENSUS: 33DATE:
05/13/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Kimberly GeorgeTIME VISIT/
INSPECTION COMPLETED:
12:15 PM
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Licensing Program Analyst (LPA) Gagandeep Singh met with facility representative, Kimberly George, for an unannounced annual inspection. Purpose of the inspection was explained. This facility operates at school site in room F1 and G1. Facility operates from 8 AM to 2:30 PM. Upon LPA’s arrival, there were 33 children in care with nine staff members. Facility is operating with in the capacity and in compliance with staff child ratio on this day.

During inspection, LPA inspected both of the classrooms and the play yard. LPA observed each classroom has fully charged fire extinguisher, fire alarms, smoke detectors, carbon monoxide detectors and working telephone. LPA did not observe any cleaning solutions, poisons and other chemicals that are dangerous to the children in the classrooms. 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. Facility has drinking water available for children. Each classroom has refrigerator to store food. All of the food is stored adequately to prevent any contamination. On the day of inspection, facility was having a vendor install new cushion material under the play structure. LPA observed the structure area was blocked for children. There is shaded area for the children to use in the play yard. LPA observed the staff took water bottles with drinking water along with them, while children were using the play yard.

LPA observed the facility has license, emergency disaster plan and all of other required documents posted in each classroom. LPA observed that facility sign in / out sheet at the entrance door of each classroom. LPA reviewed ten random children's and random staff's files. LPA observed facility has record of names, addresses and telephone numbers of each child's authorized representative. Multiple staff members have record of valid CPR card in file. LPA observed facility has fire and earthquake drill log in place and per log, last fire drill was conducted on April 17, 2024 and Earthquake drill was conducted on April 30, 2024.
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SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Gagandeep Singh
LICENSING EVALUATOR SIGNATURE: DATE: 05/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/13/2024
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: HERMAN LEIMBACH ELEMENTARY SCHOOL
FACILITY NUMBER: 343609927
VISIT DATE: 05/13/2024
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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: 05/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2024
LIC809 (FAS) - (06/04)
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