343622579-9-18-2024-03-CC-LHAM-D98PHZ-20240918112045

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343622579
Report Date: 09/18/2024
Date Signed: 09/18/2024 11:20:54 AM

Document Has Been Signed on 09/18/2024 11:20 AM - 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:	ORCHARD PRESCHOOL		FACILITY NUMBER:	343622579
ADMINISTRATOR/ DIRECTOR:	CUNNION, ELIZABETH		FACILITY TYPE:	850
ADDRESS:	1040 Q STREET		TELEPHONE:	(916) 566-1616
CITY:	RIO LINDA	STATE: CA	ZIP CODE:	95673
CAPACITY: 24	TOTAL ENROLLED CHILDREN: 24	CENSUS: 11	DATE:	09/18/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	08:50 AM
MET WITH:	Nicole Schlie		TIME VISIT/ INSPECTION COMPLETED:	11:20 AM

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 Wednesday, September 18, 2024, Licensing Program Analyst (LPA) Lea Habtom arrived to Orchard Elementary School and met with Early Childhood Special Education teacher Yvette Silva-Arreola. Shortly after Early Childhood Education coordinator Nicole Schlie arrived with the employee files. The purpose of the inspection today is to conduct a 1-year required annual inspection. The facility is located on Orchard Elementary School grounds in room 21. Facility operates two half day programs M-F 7:45 am - 10:45 am and 11:45 am to 2:45 pm. The facility provides lunch to the children. Upon arrival, LPA observed 12 preschool children being supervised by 3 staff. The site supervisor position is vacant and will be filed shortly. LPA toured the classroom and outdoor play area. The facility has exclusive use of the outdoor play ground on elementary school campus. Bathrooms were clean and sanitary in operating condition. LPA reviewed the children's Identification and Emergency Information. LPA reviewed personnel's education and immunization requirements. All staff currently employed with the center have criminal record clearances associated with the school district as well as substitutes contracted with an outside agency associated to Madison Preschool #343615667. At least one staff member present today has current EMSA approved Pediatric/Child CPR and First Aid. Facility representative 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. 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 Center Sections 101173 and 101226. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 513-0301 (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.htp. Report is continued on the following page...LIC 809-C.

SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Lea Habtom
LICENSING EVALUATOR SIGNATURE:	DATE: 09/18/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2024

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: ORCHARD PRESCHOOL	FACILITY NUMBER: 343622579
	VISIT DATE: 09/18/2024

NARRATIVE

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LPA discussed the Mandated Reporter Training with director. Beginning January 1, 2018, Health and Safety Code 1596.8662 requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Volunteers are encouraged but not required to take the training. This training requirement may be met by using the Department’s Office of Child Abuse Prevention (OCAP) online training modules. The OCAP modules are free of cost and available at: http://www.mandatedreporterca.com/. The training is currently provided in English.

LPA provided the Community Care Licensing website www.ccld.ca.gov, so the director can obtain updated licensing information, new regulations and access forms. LPA advised director of their responsibility to stay current in regards to new regulations. LPA also included the email address for the children's advocacy program to stay current on new laws childcareadvocatesprogram@dss.ca.gov.

One Title 22 regulation citation was issued during today's inspection. Exit interview conducted and report was reviewed with the facility representative Nicole Schlie, Early Childhood Education coordinator. A notice of site visit was given and must remain posted for 30 days.
Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

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.

SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Lea Habtom
LICENSING EVALUATOR SIGNATURE:	DATE: 09/18/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2024

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 09/18/2024 11:20 AM - It Cannot Be Edited

Created By: Lea Habtom On 09/18/2024 at 11:07 AM

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: ORCHARD PRESCHOOL	FACILITY NUMBER: 343622579
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/18/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

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
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in that one staff did not have proof of tuberculosis within 1 year and the health screening report which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 10/15/2024
	Plan of Correction
1 2 3 4	Proof of health screening & tuberculosis test will be emailed to LPA L. Habtom by POC date of 10/1/2024.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 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:

Seychelle De Luca

LICENSING EVALUATOR NAME:

Lea Habtom

LICENSING EVALUATOR SIGNATURE:

DATE: 09/18/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2024

LIC809 (FAS) - (06/04)

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