<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343617232
Report Date: 05/24/2022
Date Signed: 05/24/2022 01:44:50 PM

Document Has Been Signed on 05/24/2022 01:44 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:TOWN AND COUNTRY PRESCHOOLFACILITY NUMBER:
343617232
ADMINISTRATOR:JESSICA TURNERFACILITY TYPE:
830
ADDRESS:2550 BELPORT LANETELEPHONE:
(916) 487-2036
CITY:SACRAMENTOSTATE: CAZIP CODE:
95821
CAPACITY: 22TOTAL ENROLLED CHILDREN: 22CENSUS: 4DATE:
05/24/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
10:20 AM
MET WITH:Roberta ManleyTIME COMPLETED:
01:55 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On May 24, 2022 at approximately 10:20 AM Licensing Program Analysts (LPAs) Josiah Gathing and Karyn Guerra met with Director Roberta Manley for the purpose of an unannounced case management inspection. During today's inspection, LPAs observed numerous stains on the carpeted areas of the toddler and infant areas of the infant center. This poses a potential health and safety risk to infants in care.
Title 22 deficiencies for this Type B violation are cited on the following 809-D page. A copy of this report was reviewed and provided to the Director, along with Appeal Rights and a Notice of Site Visit to remain posted in the facility for 30 days.
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Josiah Gathing
LICENSING EVALUATOR SIGNATURE: DATE: 05/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/24/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
Document Has Been Signed on 05/24/2022 01:44 PM - It Cannot Be Edited


Created By: Josiah Gathing On 05/24/2022 at 12:52 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: TOWN AND COUNTRY PRESCHOOL
FACILITY NUMBER: 343617232

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/24/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/24/2022
Section Cited
CCR
101438.1(c)(1)

1
2
3
4
5
6
7
101438.1 Infant Care General Sanitation (c) ...Cleaning... requirements for areas... with infants...: (2) Carpeted floors... shall be... cleaned at least every six months, or more often if necessary.
This requirement was not met as evidenced by:
1
2
3
4
5
6
7
Facility will provide LPA with a service receipt for floor cleaning by the POC due date.
8
9
10
11
12
13
14
Based on observation, the facility did not comply with the above regulation as the infant area carpet had numerous stains, which poses Health, Safety, or Personal Rights risk to persons in care.
8
9
10
11
12
13
14

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
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:Josiah Gathing
LICENSING EVALUATOR SIGNATURE:
DATE: 05/24/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/24/2022


LIC809 (FAS) - (06/04)
Page: 2 of 2