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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343610520
Report Date: 08/19/2021
Date Signed: 08/19/2021 01:19:42 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:POPPY PATCH-PHASE IIIFACILITY NUMBER:
343610520
ADMINISTRATOR:TATE, SHANELFACILITY TYPE:
830
ADDRESS:9638 BUTTERFIELD WAYTELEPHONE:
(916) 845-4949
CITY:SACRAMENTOSTATE: CAZIP CODE:
95827
CAPACITY:60CENSUS: 18DATE:
08/19/2021
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Lea CabadingTIME COMPLETED:
01:30 PM
NARRATIVE
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Licensing Program Analysts (LPAs) Christopher Bello and Mai Lor arrived at the facility to clear deficiencies cited on 7/23/21 and met with Teacher Lea Cabading. Regarding the "Director is not spending sufficient time in the facility" deficiency, interviews with staff from Poppy Patch Phase III and Poppy Patch Phase II had conflicting information. LPAs with consultation with Licensing Program Manager Seychelle De Luca cleared the deficiency and provided Letter of Clearance. LPAs did not observe Mandated reporter training or required proof of MMR and TDAP immunizations on file for staff. This is considered as an potential risk to the children in care and a failure to correct Civil Penalty was accessed. During this inspection, LPAs observed the toddler room with one qualified teacher and two aides with 14 toddlers at approximately 10:40am placing the facility out of Teacher-child ratio. This is considered as an immediate risk to the children in care. Title 22 deficiencies are cited on the subsequent page of this report. Type Acknowledgement forms are to be signed by current parent of the facility and new parents for the next twelve months. LIC 9224 and Appeal Rights were provided. An exit interview was conducted and a Notice of Site Visit posted which must remain posted for 30 days.
SUPERVISOR'S NAME: Roxana SaraviaTELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Christopher BelloTELEPHONE: (916) 862-0844
LICENSING EVALUATOR SIGNATURE:

DATE: 08/19/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2021
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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: POPPY PATCH-PHASE III
FACILITY NUMBER: 343610520
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/19/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/20/2021
Section Cited

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A ratio of six children to each teacher shall be maintained for all children in attendance at the toddler program. An aide who is participating in on-the-job training may be substituted for a teacher when directly supervised by a fully qualified teacher.
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This requirement has not been met by evidence: LPAs observed the toddler room with 14 toddlers with one teacher and two aides.risk to the children in care. This is considered as an immediate risk to the children in care.
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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: Roxana SaraviaTELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Christopher BelloTELEPHONE: (916) 862-0844
LICENSING EVALUATOR SIGNATURE:
DATE: 08/19/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/19/2021
LIC809 (FAS) - (06/04)
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