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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343623067
Report Date: 01/07/2022
Date Signed: 01/07/2022 12:07:42 PM

Document Has Been Signed on 01/07/2022 12:07 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:KIDS INC PRESCHOOL & DISCOVERY CENTERFACILITY NUMBER:
343623067
ADMINISTRATOR:LEONARD, KIMFACILITY TYPE:
850
ADDRESS:1740 PRAIRIE CITY ROADTELEPHONE:
(916) 743-0857
CITY:FOLSOMSTATE: CAZIP CODE:
95630
CAPACITY: 72TOTAL ENROLLED CHILDREN: 72CENSUS: 54DATE:
01/07/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Alexandria GrayTIME COMPLETED:
12:30 PM
NARRATIVE
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On January 7th, 2022, Licensing Program Analyst (LPA) Kelly Ferrara conducted a Case Management Inspection and met with Co-Director Alexandria Gray. Today's census included 54 preschool children in care with nine staff.

LPA received an Unusual Incident Report from the facility regarding an incident that occurred on December 20th, 2021. During today's inspection, LPA spoke to Co-Director regarding the incident. LPA had previously spoken to Licensee Kelli Vaccaro regarding the incident over the phone. Licensee stated that she had observed a child kicking and grabbing Staff #1 while the child was upset. Licensee stated that Staff #1 then grabbed the child’s hands and held them in the child’s lap, thereby restraining the child. Licensee stated Staff #1 has been terminated from Kids Inc.

Based on the information received, a Title 22 personal rights violation has occurred. See page 809-D for deficiency cited. Exit interview was conducted and a copy of this report was given to the Co-Director. Notice of site was given and must remain posted for 30 days.
SUPERVISORS NAME: Maria Mayorga
LICENSING EVALUATOR NAME: Kelly Ferrara
LICENSING EVALUATOR SIGNATURE: DATE: 01/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/07/2022
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 01/07/2022 12:07 PM - It Cannot Be Edited


Created By: Kelly Ferrara On 01/07/2022 at 08:24 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
, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: KIDS INC PRESCHOOL & DISCOVERY CENTER
FACILITY NUMBER: 343623067

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/07/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/12/2022
Section Cited
CCR
101223(a)(3)

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Personal Rights (a)The licensee shall ensure that each child is accorded the following personal rights: (3) To be free from corporal or unusual punishment…or other actions of a punitive nature… This requirement was not met as evidenced by: Licensee stated that Staff #1 grabbed a child by their hands
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Licensee stated Staff #1 has been terminated and LPA did not observe them on the premises. Co-Director stated that she will conduct a staff training by having staff watch the Personal Rights video on CCLD.ca.gov and use a written article. Facility will submit training materials and staff signatures to LPA by POC due date.
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and held them in the child’s lap, thereby restraining the child. This is a health 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:Maria Mayorga
LICENSING EVALUATOR NAME:Kelly Ferrara
LICENSING EVALUATOR SIGNATURE:
DATE: 01/07/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/07/2022


LIC809 (FAS) - (06/04)
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