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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343610256
Report Date: 08/06/2024
Date Signed: 08/06/2024 02:07:50 PM

Document Has Been Signed on 08/06/2024 02:07 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:CADENCE EDUCATION LLC - WILLARDFACILITY NUMBER:
343610256
ADMINISTRATOR/
DIRECTOR:		REBECCA MICHAELFACILITY TYPE:
850
ADDRESS:640 WILLARD DRIVETELEPHONE:
(916) 353-1031
CITY:FOLSOMSTATE: CAZIP CODE:
95630
CAPACITY: 185TOTAL ENROLLED CHILDREN: 185CENSUS: 71DATE:
08/06/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:40 AM
MET WITH:Rebecca MichaelTIME VISIT/
INSPECTION COMPLETED:
02:20 PM
NARRATIVE
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Licensing Program Analyst (LPA) Erwina Pascual-Golamco and LPA Jennifer Velasco met with Facility Representative, Rebecca Michael (Representative), for a case management inspection regarding a self-reported incident on 07/29/2024. The purpose of the inspection was explained to Representative.

Representative self-reported and submitted a written Unusual Incident Report LIC 624 (UIR) to document that on 07/29/2024, a staff member left a child (Child1) unattended in the bathroom for approximately one minute while transitioning from the classroom to the outdoor play yard. Staff members informed Representative about the incident, and Representative investigated, interviewed staff, and notified Child1's parent and the Department.

Based on interview and record reviews, a Title 22 Deficiency has been issued on the attached LIC 809-D page. Representative was informed that the deficiency cited today is a Type A deficiency. Because this is a repeated citation for the same deficiency within the last 12 months, which the facility incurs an immediate civil penalty assessed in the amount of $1,000. Representative shall also provide a copy of this licensing report to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. Exit interview was conducted, appeal rights were provided, and notice of site visit was given to Representative, who will post it where visible to parents/guardians for 30 days. A signed Acknowledgement of Receipt of the Licensing Report (LIC 9224) must be placed in each child's file for verification.
SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Jennifer Velasco
LICENSING EVALUATOR SIGNATURE: DATE: 08/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/06/2024
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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Document Has Been Signed on 08/06/2024 02:07 PM - It Cannot Be Edited


Created By: Jennifer Velasco On 08/06/2024 at 07:36 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: 08/06/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/07/2024
Section Cited
CCR
101229(a)(1)

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(a)The licensee shall provide care and supervision as necessary to meet the children's needs. (1) No child(ren) shall be left without the supervision of a teacher at any time...shall include visual observation. This requirement was not met as evidenced by: Based on witness statements and record
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Facility representative stated she has already done a best practices review and review of name to face procedures, and will develop a detailed written plan for ensuring there is not another incident of absence of supervision. Representative stated she will email to LPA by close of business POC due date
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 reviews, the facility did not comply with the section cited above as a child was left unsupervised in the bathroom for approximately one minute in this self-reported incident. This poses an immediate health, safety, or personal rights risk to persons in care.
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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: 08/06/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/06/2024


LIC809 (FAS) - (06/04)
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