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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343621912
Report Date: 10/08/2021
Date Signed: 10/08/2021 03:55:06 PM

Document Has Been Signed on 10/08/2021 03:55 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 (PS)FACILITY NUMBER:
343621912
ADMINISTRATOR:MOORE, FRISHAFACILITY TYPE:
850
ADDRESS:8699 ELK GROVE BLVDTELEPHONE:
(916) 405-0448
CITY:ELK GROVESTATE: CAZIP CODE:
95624
CAPACITY: 71TOTAL ENROLLED CHILDREN: 71CENSUS: 15DATE:
10/08/2021
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
10:11 AM
MET WITH:Frisha Castro & Patty "PJ" GiustiTIME COMPLETED:
03:30 PM
NARRATIVE
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On 10/8/2021 at 10:11am Licensing Program Analyst (LPA) Morgan Pringle met with Director Frisha Castro and Owner Patty (PJ) Giusti for an Unannounced Annual Inspection. Four (4) rooms were toured for a health and safety inspection. Fifteen (15) preschool children and two (2) staff members were present during the inspection. Director informed LPA that the facility has four (4) rooms for preschool, but due to the Covid-19 pandemic and low enrollment, only two (2) rooms are currently being used. LPA 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 and toilets were observed to be clean and in proper working order. The counters were observed to be clean and free from hazards. All water bottles were properly stored and labeled. 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. All children’s files were complete. During Record Review of staff files, LPA observed two (2) missing Mandated Reporter Certificates, one (1) missing immunization record for MMr and Tdap, one (1) Proof of a TB test and well as one (1) missing Health Screening Report and one (1) proof of Health and Safety Training (see 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 (PS)
FACILITY NUMBER: 343621912
VISIT DATE: 10/08/2021
NARRATIVE
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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)
Page: 2 of 5
Document Has Been Signed on 10/08/2021 03:55 PM - It Cannot Be Edited


Created By: Morgan Pringle On 10/08/2021 at 03:28 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 (PS)
FACILITY NUMBER: 343621912

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
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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
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Director will make sure to obtain proof of immunizations for both staff members. Director will submit proof to LPA by correction date.
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
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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
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Director will make sure to obtainMandated Reporter training certificates for both staff members. Director will submit proof to LPA by correction date.
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)
Page: 3 of 5
Document Has Been Signed on 10/08/2021 03:55 PM - It Cannot Be Edited


Created By: Morgan Pringle On 10/08/2021 at 03:28 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 (PS)
FACILITY NUMBER: 343621912

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/08/2021

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101215.1(m)
Child Care Center Director Qualifications and Duties
(m) A child care center director shall complete 16 hours of health and safety training if necessary pursuant to Health and Safety Code Section 1596.866.

This requirement is not met as evidenced by:
Deficient Practice Statement
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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: 10/15/2021
Plan of Correction
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Director will ensure registration for a Health and Safety course. Director will submit receipt of registration to LPA.
Type B
Section Cited
CCR
101216(g)(1)
Personnel Requirements
(1) Except as specified in (3) below, good physical health shall be verified by a health screening, including a test for tuberculosis, performed by or under the supervision of a physician not more than one year prior to or seven days after employment or licensure.

This requirement is not met as evidenced by:
Deficient Practice Statement
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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
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Director will submit proof of report to LPA and place in staff file.
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)
Page: 5 of 5
Document Has Been Signed on 10/08/2021 03:55 PM - It Cannot Be Edited


Created By: Morgan Pringle On 10/08/2021 at 03:28 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 (PS)
FACILITY NUMBER: 343621912

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/08/2021

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101216(g)(2)
Personnel Requirements
(2) Each person specified in (g) above shall have a health-screening report signed by the person performing the screening. This report shall indicate the following:

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 in which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/22/2021
Plan of Correction
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2
3
4
Director will submit proof of report to LPA
Section Cited
Deficient Practice Statement
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2
3
4
POC Due Date:
Plan of Correction
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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: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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