343610472-6-20-2024-03-CC-DVAG-D6EV4G-20240620160619

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343610472
Report Date: 06/20/2024
Date Signed: 06/20/2024 04:06:25 PM

Document Has Been Signed on 06/20/2024 04:06 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:	NORALTO PRESCHOOL CENTER		FACILITY NUMBER:	343610472
ADMINISTRATOR/ DIRECTOR:	MARIAM ISEMERIO		FACILITY TYPE:	850
ADDRESS:	477 LAS PALMAS AVENUE		TELEPHONE:	(916) 566-2700
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95815
CAPACITY: 72	TOTAL ENROLLED CHILDREN: 72	CENSUS: 9	DATE:	06/20/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	01:00 PM
MET WITH:	Fong Khamnivong		TIME VISIT/ INSPECTION COMPLETED:	04:30 PM

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At 1:00 p.m. on Thursday, June 20th, 2024, Licensing Program Analyst (LPA) Pa Dao Vang met with Facility Respresentative, Fond Khamnivong, for the purpose of an unannounced annual inspection. LPA observed a census of 9 children supervised by 3 staff. Facility hours of operation are from 7:00 a.m. - 5:00 p.m., Mondays thru Fridays. Center provide breakfast, lunch, and snack for the children.

Site Supervisor was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA conducted a health and safety inspection of the classroom, and restrooms. LPA observed the following documents are posted: License, Emergency Disaster Plan, Personal Rights, Parents' Rights Poster, and menus. Director stated that there are no firearms nor poisons on the premises. LPA observed an expired fire drill log with the last date of 6/5/2023.

Facility provides Incidental Medical Services. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

LPA conducted a health and safety inspection of the outdoor space. Playground equipment and surfaces were free of loose or sharp parts. Water is accessible via labeled bottles. Children are also provide with water bottles. Facility provided filter water with small plastic cups for children. LPA inspected two separate play structures outside with little to no shade for children to rest. One of the playgrounds have a small canopy covering less than half of the play structure. The other have no shade provided for children.

Continue report on LIC809-C...

SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Dao Vang
LICENSING EVALUATOR SIGNATURE:	DATE: 06/20/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2024

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 06/20/2024 04:06 PM - It Cannot Be Edited

Created By: Dao Vang On 06/20/2024 at 03:28 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: NORALTO PRESCHOOL CENTER	FACILITY NUMBER: 343610472
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/20/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101238.2(b)(1)

Outdoor Activity Space

(1) Provide a shaded rest area for the children. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview, andrecord review, the licensee did not comply with the section cited above in which LPA inspected two separate play structures outside with little to no shade for children to rest. One of the playgrounds have a small canopy covering less than half of the play structure. The other have no shade provided, which posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 07/22/2024
	Plan of Correction
1 2 3 4	Facility Respresentative will obtain staff's LIC503 form and email a copy to LPA's email.

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
1 2 3 4	Based on observation, interview, and record reviews, the licensee did not comply with the section cited above 1 out of 3 staff files is missing the LIC503 Heath Screening form, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 07/22/2024
	Plan of Correction
1 2 3 4	Facility Resentative will send photos to LPA's email of the play structures with shade for children to rest.

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:

Seychelle De Luca

LICENSING EVALUATOR NAME:

Dao Vang

LICENSING EVALUATOR SIGNATURE:

DATE: 06/20/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2024

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: NORALTO PRESCHOOL CENTER	FACILITY NUMBER: 343610472
	VISIT DATE: 06/20/2024

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LPA reviewed staff and children's records. Each child's file contained an admission agreement, emergency card, immunization, and acknowledgement of receipt of personal rights, consent for emergency medical treatment, and parent’s rights. LPA observed CPR and First aid certification for at least one staff on the facility premises. LPA observed current AB 1207 Mandated Reporter training certificates, employee rights, and documentation of the educational background, training, and/or experience. There is at least 1 staff with current CRP/First Aid certification. LPA observed 1 out of 3 staff missing the LIC503 Health Screening form in the file. LPA printed a copy of the LIC503 for staff to complete.

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. LPA Vang reviewed the lead testing results completed on 12/7/2022 with no exceedence.

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).

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.

The Title 22 deficiencies are cited on LIC809-D page. An exit interview was conducted and the report was reviewed with Facility Representative, Fong Khamnivong. A copy of this report and appeal rights were discussed and left with Facility Representative. A notice of site visit was provided and posted by LPA and must remain posted for 30 days.

SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Dao Vang
LICENSING EVALUATOR SIGNATURE:	DATE: 06/20/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2024

LIC809 (FAS) - (06/04)

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