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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343621911
Report Date: 12/18/2020
Date Signed: 12/18/2020 04:25:59 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:MOORE LEARNING PRESCHOOL & DCC (INF)FACILITY NUMBER:
343621911
ADMINISTRATOR:MOORE, FRISHAFACILITY TYPE:
830
ADDRESS:8699 ELK GROVE BLVDTELEPHONE:
(916) 405-0448
CITY:ELK GROVESTATE: CAZIP CODE:
95624
CAPACITY:20CENSUS: 0DATE:
12/18/2020
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Frisha MooreTIME COMPLETED:
11:10 AM
NARRATIVE
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Licensing Program Analyst (LPA) Amy Silva conducted a tele-inspection via Facetime with Owner Frisha Moore for the purpose of an unannounced case management inspection. LPA informed Ms. Moore that due to the current COVID-19 State of Emergency, the Department is not conducting physical inspections at this time. Based on information that was self-reported by Ms. Moore, LPA Silva learned that Staff S1 fed Child C1 the wrong bottle of breast milk. Staff S1 failed to adhere to the requirements provided in California Code of Regulations, Title 22 for food services. According to regulation 101227 (14) food services, all persons engaged in food preparation and service shall observe personal hygiene and food-service sanitation practices that protect food from contamination. As soon as the incident took place, Staff S1 made Ms. Moore aware of the incident and Ms. Moore immediately called the parents of Child C1 and Child C2 to explain the situation. Ms. Moore immediately spoke with Staff S2 to inquire if she would be interested in stepping up into a new position, as the Infant Toddler Supervisor. Staff S2 accepted the offer. Staff S2 will work with Ms. Moore in developing a plan to ensure an incident like this doesn’t occur again.

Type B deficiency was cited on subsequent page.

Exit interview was conducted. Notice of Site Visit and a copy of this report was provided and must be posted for 30 days.

SUPERVISOR'S NAME: Bettina EngelmanTELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Amy SilvaTELEPHONE: (916) 926-9100
LICENSING EVALUATOR SIGNATURE:

DATE: 12/18/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2020
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: MOORE LEARNING PRESCHOOL & DCC (INF)
FACILITY NUMBER: 343621911
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/18/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/18/2020
Section Cited

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Food Services (14) All persons engaged in food preparation and service shall observe personal hygiene and food-service sanitation practices that protect food from contamination.
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This requirement is not met as evidenced by: LPA learned upon information that was self-reported by Ms. Moore, that staff S1 fed child C1 the wrong bottle of breast milk.
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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: Bettina EngelmanTELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Amy SilvaTELEPHONE: (916) 926-9100
LICENSING EVALUATOR SIGNATURE:
DATE: 12/18/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/18/2020
LIC809 (FAS) - (06/04)
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