343621911-10-8-2021-53-CC-MPRE-C7LUWT-20211008155716

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343621911
Report Date: 10/08/2021
Date Signed: 10/08/2021 03:57:23 PM

Document Has Been Signed on 10/08/2021 03:57 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME:	MOORE LEARNING PRESCHOOL & DCC (INF)		FACILITY NUMBER:	343621911
ADMINISTRATOR:	MOORE, FRISHA		FACILITY TYPE:	830
ADDRESS:	8699 ELK GROVE BLVD		TELEPHONE:	(916) 405-0448
CITY:	ELK GROVE	STATE: CA	ZIP CODE:	95624
CAPACITY: 20	TOTAL ENROLLED CHILDREN: 20	CENSUS: 7	DATE:	10/08/2021
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	10:11 AM
MET WITH:	Frisha Castro & Patty "PJ" Giusti		TIME COMPLETED:	03:30 PM

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On 10/8/2021 at 10:11am Licensing Program Analyst (LPA) Morgan Pringle met with Director Frisha Moore and Owner Patty (PJ) Giusti for an Unannounced Annual Inspection. One (1) room was toured for a health and safety inspection. Seven (7) infants and two (2) staff members were present during the inspection. The facility operates from 7:00am – 5:30pm. Director left the facility at 12:45pm. Report overview was done with Owner.

The facility has age appropriate materials in the classroom that are observed to be clean and in good condition. The outdoor space has ample shade for the children and has proper materials for the children. All toxins, cleaning products, and hazardous materials were observed to be in inaccessible areas. All sinks were observed to be clean and in proper working order. The counters were observed to be clean and free from hazards. All bottles and food were properly stored and labeled. The cribs were free from all hazards. Each infant was observed to have an Individual Infant Sleeping Plan as well as a Needs and Services Plan. LPA did not observe any harmful or unattended bodies of water in or around the facility.

The facility is operating within its licensed capacity and is in ratio. All proper postings are made visible in the entry way of the facility. The fire/disaster drill log was complete with the last drill logged 9/3/2021. A physical census of the children and staff was taken and cross referenced with the sign-in and out log. All children are accounted for and properly signed in/out. LPA obtained a sample of the children’s files and the staff files. Through record review LPA observed T1 was missing proof of MMr and Tdap immunization (see LIC809-D). LPA observed C1 was missing a Physicians Report (see LIC809-D) and C2 was missing the signed portion of the Personal rights and Parents Rights forms (see LIC9102TV)

Continued on LIC809-D

SUPERVISORS NAME: Justin L Denton
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE:	DATE: 10/08/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2021

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: MOORE LEARNING PRESCHOOL & DCC (INF)	FACILITY NUMBER: 343621911
	VISIT DATE: 10/08/2021

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Owner was reminded that EMSA approved Pediatric CPR & First Aid training must be completed every two (2) years. Personnel Roster must be properly maintained, and fire/disaster drill must be conducted every six (6) months and documented. Owner was reminded that California Law requires all facilities to report unusual incidents or injuries to children in care, to child's parents, and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624). Incidents must be reported within 24 hours by phone, fax, or email. LPA informed Owner that all forms can be downloaded at www.ccld.ca.gov. Owner was also informed that Mandated Reporter Training ("General" and "Child Care Providers") is required for all staff and is to be renewed every 2 years by visiting www.mandatedreporterca.com.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. 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.

Owner 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.

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.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with Owner PJ Giusti.

SUPERVISORS NAME: Justin L Denton
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE:	DATE: 10/08/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2021

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 10/08/2021 03:57 PM - It Cannot Be Edited

Created By: Morgan Pringle On 10/08/2021 at 03:27 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: MOORE LEARNING PRESCHOOL & DCC (INF)	FACILITY NUMBER: 343621911
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/08/2021

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 record review, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 10/22/2021
	Plan of Correction
1 2 3 4	Facility will sure that the staff member submits proof of MMr and Tdap by 10/22/2021. Director will submit proof of immunization to LPA.

Type B

Section Cited

CCR

101220(a)

Child's Medical Assessments

(a) Prior to, or within 30 calendar days following the enrollment of a child, the licensee shall obtain a written medical assessment of the child. This medical assessment enables the licensee to assess whether the center can provide necessary health-related services to the child. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 10/31/2021
	Plan of Correction
1 2 3 4	Director will ensure childs receives a completed Physicians Report and place in child's file. Director will submit proof of report to LPA.

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:

Justin L Denton

LICENSING EVALUATOR NAME:

Morgan Pringle

LICENSING EVALUATOR SIGNATURE:

DATE: 10/08/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2021

LIC809 (FAS) - (06/04)

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