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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343622428
Report Date: 02/14/2024
Date Signed: 02/14/2024 01:00:23 PM

Document Has Been Signed on 02/14/2024 01:00 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:VILLAGE PRESCHOOL CENTERFACILITY NUMBER:
343622428
ADMINISTRATOR:TOMIKA RAINEARFACILITY TYPE:
850
ADDRESS:6845 LARCHMONT DRIVETELEPHONE:
(916) 566-3485
CITY:NORTH HIGHLANDSSTATE: CAZIP CODE:
95660
CAPACITY: 32TOTAL ENROLLED CHILDREN: 26CENSUS: 22DATE:
02/14/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Martina Hernandez and Corrie BuckmasterTIME COMPLETED:
01:10 PM
NARRATIVE
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On Wednesday, February 14, 2024 at 11:45 AM, Licensing Program Analysts (LPAs) Tanya Washington and Fabian Schwartz met with Facility Representative Martina Hernandez and Early Learning Director Corrie Buckmaster for an unannounced case management inspection. Upon arrival LPAs observed four staff providing care and supervision to 19 preschool aged children. LPAs also observed three toddler children being cared by two other staff in a separate part of the classroom.

During today's inspection, LPAs conducted interviews with staff, reviewed records and toured the facility.

On February 13, 2024, Facility self reported an unusual incident which occurred on February 6, 2024. It was reporter that around 11:26 AM, Staff #1 was transitioning a group of nine children from outdoor playground inside the classroom. During the transition Child #1 was left behind on the playground unattended. Staff #2 located Child #1 at 11:32 AM, and returned the child to the classroom safely.

The absence of supervision was for approximately six minutes.

Facility management reminded staff to ensure all children are accounted for during transitions between indoor and outdoor activities. Additionally, staff will be retrained on supervision protocols to prevent similar incidents from happening in the future.

Upon receipt, facility representative shall post and provide copies of this licensing report to parents/ guardians of children who are currently enrolled as well as parents/ guardians of children newly enrolled at the facility during the next 12 months. Parents/guardians must acknowledge receipt of this report and citation by signing a LIC9224, “ACKNOWLEDGEMENT OF RECEIPT OF LICENSING REPORTS”. A copy of this form should be placed in each child file upon receipt from parent.
Refer to LIC809D for citation information.

LPAs discussed this report with facility representative and conducted an exit interview. LPA also provided appeal rights. Notice of site visit posted.
SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Tanya Washington
LICENSING EVALUATOR SIGNATURE: DATE: 02/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/14/2024
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 02/14/2024 01:00 PM - It Cannot Be Edited


Created By: Tanya Washington On 02/14/2024 at 12:06 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: VILLAGE PRESCHOOL CENTER
FACILITY NUMBER: 343622428

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/14/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/15/2024
Section Cited
CCR
101229(a)(1)

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The licensee shall provide care and supervision as necessary to meet the children's needs. No child(ren) shall be left without the supervision of a teacher at any time, except as specified in
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Facility Representative will submit plan of correction to LPA by POC date of 02/15/2024.
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Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation. This requirement is not met as evidenced: Facility self reported an incident of Child #1 being left unattended on the playground for approximately 6 minutes. This is an immediate heath and safety risk to children in care.
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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:Amanda Blesi
LICENSING EVALUATOR NAME:Tanya Washington
LICENSING EVALUATOR SIGNATURE:
DATE: 02/14/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/14/2024


LIC809 (FAS) - (06/04)
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