343615018-6-10-2022-03-CC-ATIY-CF9SFJ-20220610135026

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343615018
Report Date: 06/10/2022
Date Signed: 06/10/2022 01:50:36 PM

Document Has Been Signed on 06/10/2022 01:50 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME:	CALVARY CHRISTIAN CENTER PRESCHOOL		FACILITY NUMBER:	343615018
ADMINISTRATOR:	LANE, CLASSIC		FACILITY TYPE:	850
ADDRESS:	2727 DEL PASO BLVD.		TELEPHONE:	(916) 921-9303
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95815
CAPACITY: 60	TOTAL ENROLLED CHILDREN: 60	CENSUS: 8	DATE:	06/10/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:15 PM
MET WITH:	Classic Lane		TIME COMPLETED:	02:05 PM

NARRATIVE

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On June 10, 2022, at approximately 12:15 PM, Licensing Program Analyst (LPA) Alize Tillery met with Director Classic Lane for the purpose of an unannounced required 1 year annual inspection. Upon arrival, LPA observed 8 children supervised by 2 staff. The facility hours of operation are Monday through Friday from 6:30 AM to 6:00 PM. The facility does not offer transportation services.

LPAs toured all activity and classroom spaces (Cornerstones Room), restrooms, kitchen and outdoor play area. The other classrooms are being used as storage space due to low enrollment. LPA observed the following documents are posted: License, Emergency Disaster Plan, Personal Rights, Parents' Rights Poster, and daily schedule. Cleaning disinfectants, medications and hazardous items are appropriately stored and inaccessible to children. Director stated there are no poisons or firearms on the premises. Furniture and equipment are in good condition. Toileting facilities are in safe, sanitary condition. One out of the 4 toilets is out of order; Director stated that maintenance has been contacted and they are waiting for someone to come out and fix it. The floors appeared to be clean throughout the facility. The program provides breakfast, lunch and a snack. LPA discussed COVID19 guidelines with Director.

LPA observed trash bins with tight fitted lids. Drinking water is readily available to children both indoors and outdoors. Director stated that there is a water pitcher that is used and children’s personal cups. LPAs observed the facility’s sign in and out system. Facility has record of conducting fire drills at least every six months; last fire drill was conducted on 05/13/2022. Playground equipment and surfaces are free of loose or sharp parts. There are sufficient equipment and toys, and there are shaded areas supplied by a tent and large trees.

Report continues on 809-C.

SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Alize Tillery
LICENSING EVALUATOR SIGNATURE:	DATE: 06/10/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2022

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 06/10/2022 01:50 PM - It Cannot Be Edited

Created By: Alize Tillery On 06/10/2022 at 01:35 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
, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: CALVARY CHRISTIAN CENTER PRESCHOOL	FACILITY NUMBER: 343615018
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/10/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on interview and record review, the licensee did not comply with the section cited above in that all staff present today did not have a current Mandated Reporter Certificate, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 06/30/2022
	Plan of Correction
1 2 3 4	Director with submit proof to LPA TIllery of current Mandated Reporter Certificates, for all staff.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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:

Alize Tillery

LICENSING EVALUATOR SIGNATURE:

DATE: 06/10/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2022

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: CALVARY CHRISTIAN CENTER PRESCHOOL	FACILITY NUMBER: 343615018
	VISIT DATE: 06/10/2022

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3 staff and 8 children's records were reviewed. Both children and staff files were observed to be complete. At least one staff member present today has a current Pediatric CPR and First Aid certification that expires on in 9/2023. LPA observed a current Children’s Roster. LPA observed a functional carbon monoxide detector, smoke detector and fire extinguisher. LPA reminded Licensees that 100% supervision is required at all times. LPA reviewed the Department's inspection authority and discussed with designee any changes that may occur regarding the director or an employee acting in the director's absence must be reported to department within ten working days.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA is 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

Director 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.

A deficiency is cited on the following 809D page.

A notice of site visit was given and must remain posted for 30 days. An exit interview was conducted and the report was reviewed with the Director, Classic Lane.

SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Alize Tillery
LICENSING EVALUATOR SIGNATURE:	DATE: 06/10/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2022

LIC809 (FAS) - (06/04)

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