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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343610256
Report Date: 12/15/2023
Date Signed: 12/15/2023 10:09:30 AM

Document Has Been Signed on 12/15/2023 10:09 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:CADENCE EDUCATION LLC - WILLARDFACILITY NUMBER:
343610256
ADMINISTRATOR:REBECCA MICHAELFACILITY TYPE:
850
ADDRESS:640 WILLARD DRIVETELEPHONE:
(916) 353-1031
CITY:FOLSOMSTATE: CAZIP CODE:
95630
CAPACITY: 185TOTAL ENROLLED CHILDREN: 185CENSUS: 106DATE:
12/15/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Rebecca MichaelTIME COMPLETED:
10:15 AM
NARRATIVE
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On 12/15/2023, Licensing Program Manager (LPM) Natalie Dunaway and Licensing Program Analyst (LPA) Stephanie Piring and LPA Jennifer Velasco met with Facility Representative, Director Rebecca Michael (Director), for the purpose of conducting a Case Management Inspection.

Sacramento Regional Office (RO) received an Unusual Incident Report (UIR) from the facility regarding an incident that occurred on 11/28/2023. During today's inspection, LPA interviewed Director regarding the incident. LPA learned that a child (Child1) was left unattended inside of a classroom bathroom for approximately two minutes. Child1's teacher (Staff1), who was outside with their class, asked a teacher (Staff2) from another class to take Child1 to the bathroom. There was then a change in that classroom, and another teacher (Staff3) lined up those children and took them outside. During this transition, Staff2 spoke with a parent in the hallway and then returned to the classroom and found Child1 in the bathroom on the toilet, saying they were done. Staff2 assisted Child1 and took Child1 outside with their original class.

Director stated that the staff involved were trained on communicating changes in child count with other staff, doing name to face child checks during transitions, and checking the classroom and bathroom thoroughly before leaving the classroom. Director stated staff did not follow the facility's protocol during this incident.

Based on the information received, a violation of Title 22 regulations has occurred. One deficiency was cited on the attached LIC 809-D. Exit interview was conducted and a copy of this report was given to the Director. Notice of site was given and must remain posted for 30 days. Appeal rights provided.

SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Jennifer Velasco
LICENSING EVALUATOR SIGNATURE: DATE: 12/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/15/2023
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 2
Document Has Been Signed on 12/15/2023 10:09 AM - It Cannot Be Edited


Created By: Jennifer Velasco On 12/15/2023 at 09:35 AM
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: CADENCE EDUCATION LLC - WILLARD
FACILITY NUMBER: 343610256

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/15/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/19/2024
Section Cited
CCR
101229(a)(1)

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Responsibility for Providing Care and Supervision. The licensee shall provide care and supervision as necessary to meet the children's needs. No child shall be left without the supervision of a teacher at any time..Supervision shall include visual observation.
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Director stated they have given one-on-one training regarding safety and supervision, espeically during transitions, and will address this in a whole staff meeting.
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This requirement was not met as evidenced by: The facility self-reported that Child 1 was left in a classroom bathroom without staff supervision for two minutes. This is a potential health, safety, and/or personal rights risk to children in care.
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Director statyed they will provide to LPA a copy of the agenda and sign-in sheet for staff who attended/completed the training.

LPA email:
jennifer.velasco@dss.ca.gov

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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:Natalie Dunaway
LICENSING EVALUATOR NAME:Jennifer Velasco
LICENSING EVALUATOR SIGNATURE:
DATE: 12/15/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/15/2023


LIC809 (FAS) - (06/04)
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