343615018-9-13-2024-03-CC-DVAG-D93SKW-20240913135724

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343615018
Report Date: 09/13/2024
Date Signed: 09/13/2024 01:57:34 PM

Document Has Been Signed on 09/13/2024 01:57 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:	CALVARY CHRISTIAN CENTER PRESCHOOL		FACILITY NUMBER:	343615018
ADMINISTRATOR/ DIRECTOR:	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: 6	DATE:	09/13/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	10:30 AM
MET WITH:	Classic Lane		TIME VISIT/ INSPECTION COMPLETED:	02:30 PM

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At 10:30a.m. on Friday, September 13th, 2024, Licensing Program Analyst (LPA) Pa Dao Vang met with Director Classic Lane for the purpose of an unannounced, annual required inspection. LPA observed a census of 6 children supervised by 2 staff. Facility hours of operation are from 6:30 a.m. - 6:00 p.m., Mondays thru Fridays. Center provides breakfast, lunch, and p.m. snack for the children. The facility does not offer transportation services.

Director was reminded that all adults 18 years of age 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 (Cornerstones Room), restrooms, and food service area. The facility is using Classrooms 1, 2 and 3 for storage. LPA observed the following documents are posted: License, Emergency Disaster Plan, Personal Rights, Parents' Rights Poster, Earthquake Preparedness, Child Passenger Restraint Poster, Parent’s Notification, LIC613A Person Rights, Daily Activity Schedule, and menus. Cleaning disinfectants, medications and hazardous items are appropriately stored and inaccessible to children. Furniture and equipment are in good condition. LPA observed a drinking fountain taped off in the Cornerstone room. Director stated the drinking fountain was taped off since COVID and they’ve decided to not reopen it. Drinking water is accessible via water bottles, water filter container, and cups. The water bottles are transitioned with children to different environments.

Continue report on LIC809-C...

SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Dao Vang
LICENSING EVALUATOR SIGNATURE:	DATE: 09/13/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2024

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 09/13/2024 01:57 PM - It Cannot Be Edited

Created By: Dao Vang On 09/13/2024 at 12:41 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: CALVARY CHRISTIAN CENTER PRESCHOOL	FACILITY NUMBER: 343615018
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/13/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.7995(a)(1)

General Provisions and Definitions

(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview, record reviews, the licensee did not comply with the section cited above in 2 out of 3 staff missing MMR or Tdap in their personnel files, which posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 10/14/2024
	Plan of Correction
1 2 3 4	Director will obtain copies of staff's immunization and will email them to LPA. LPA provided a copy of her business card to Director. LPA then will clear the POC by the due date of 10/14/2024.

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:

Dao Vang

LICENSING EVALUATOR SIGNATURE:

DATE: 09/13/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2024

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: CALVARY CHRISTIAN CENTER PRESCHOOL	FACILITY NUMBER: 343615018
	VISIT DATE: 09/13/2024

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LPA observed trash bins with tight fitted lids. Toileting facilities are in safe, sanitary condition. The floors appeared to be clean throughout the facility. Director stated that there is no smoking, no firearms nor poisons on the premises. 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 08/18/2024.

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. The play structure is free of loose or sharp parts with proper cushioning under it. Outdoor shade was provided by canopy, building, and trees.

LPA reviewed staff and children's records. LPA observed current employee rights, and documentation of the educational background, training, and/or experience. There is at least 1 staff with current CRP/First Aid certification in the facility. LPA observed 2 out of 3 staff missing current MMR or Tdap records in the files.

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.

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 childcare 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). Director stated the lead testing was completed in 2023 and will obtain a copy of the results. Director will also email a copy to LPA.

Continue report on LIC809-C...

SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Dao Vang
LICENSING EVALUATOR SIGNATURE:	DATE: 09/13/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2024

LIC809 (FAS) - (06/04)

Page: 3 of 4

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: CALVARY CHRISTIAN CENTER PRESCHOOL	FACILITY NUMBER: 343615018
	VISIT DATE: 09/13/2024

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Facility Representative was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

A deficiency is being cited based on LPA’s observation, interview conducted, and record reviews in accordance with the California Code of Regulations, Title 22, see LIC809-D page. An exit interview was conducted with Director Classic Lane. A copy of the appeal rights and a notice of site visit were also provided to Director. Notice of site visit shall remain posted for a period of 30 consecutive days.

SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Dao Vang
LICENSING EVALUATOR SIGNATURE:	DATE: 09/13/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2024

LIC809 (FAS) - (06/04)

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