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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343623067
Report Date: 07/18/2023
Date Signed: 07/18/2023 01:21:59 PM

Document Has Been Signed on 07/18/2023 01:21 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:KIDS INC PRESCHOOL & DISCOVERY CENTERFACILITY NUMBER:
343623067
ADMINISTRATOR:KIM LEONARDFACILITY TYPE:
850
ADDRESS:1740 PRAIRIE CITY ROADTELEPHONE:
(916) 743-0857
CITY:FOLSOMSTATE: CAZIP CODE:
95630
CAPACITY: 100TOTAL ENROLLED CHILDREN: 100CENSUS: 73DATE:
07/18/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Kelli VaccaroTIME COMPLETED:
01:50 PM
NARRATIVE
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Licensing Program Analyst Jennifer Velasco (LPA) conducted an unannounced case management inspection and met with Facility Representative Kelli Vaccaro (D1). LPA toured the preschool facility, including all activity and classroom spaces, restrooms, food service and outdoor play areas. Upon arrival, LPA observed 73 children in care being supervised by 11 classroom staff. D1 was reminded never to exceed the conditions, limitations, and capacity specified on the license. Facility hours of operation are Monday through Friday from 6:30 AM to 6:00 PM.

The purpose of today's case management inspection is to follow up on a self-reported incident in which a child (C1) was left unsupervised in a classroom while the staff (S1) took the rest of the class outside to the playground. During today's inspection, LPA conducted witness interviews, reviewed facility documents, and observed staff providing care to children. Witness statements and facility documentation provided evidence that the facility failed to provide supervision to a child for four minutes.

A Title 22 deficiency is cited on the subsequent page of this report. Licensee acknowledges, that FOR TYPE A DEFICIENCIES ONLY upon receipt, licensee shall post LIC 809-D with Type A deficiencies for 30 days and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. LIC 9224 must be signed by parents/guardians and kept with the children's forms as a receipt whenever any Type A documents are provided by the licensee. LIC 9224 and Appeal Rights were provided. D1's signature on this report acknowledges receipt of these rights. This report was reviewed with D1. An exit interview was conducted. A Notice of Site Visit was provided and shall remain posted for a period of 30 days.
SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Jennifer Velasco
LICENSING EVALUATOR SIGNATURE: DATE: 07/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/18/2023
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 07/18/2023 01:21 PM - It Cannot Be Edited


Created By: Jennifer Velasco On 07/18/2023 at 09:14 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: KIDS INC PRESCHOOL & DISCOVERY CENTER
FACILITY NUMBER: 343623067

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/18/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/19/2023
Section Cited
CCR
101229(a)(1)

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a) The licensee shall provide care and supervision as necessary to meet the children's needs. (1) No child(ren) shall be left without the supervision of a teacher at any time... Supervision shall include visual observation. This requirement was not met, as evidenced
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Facility representative (D1) stated they will develop a detailed written plan to ensure this does not happen again. D1 stated the plan will include staff training on supervision, especially during transitions, and observation of staff implementation of that training. D1 stated they will email the detailed written plan and
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by: Based on record review and interview, the above requirement was not met, as a child was left in the classroom, alone and unsupervised, for a period of four minutes. This poses an immediate risk to the health, safety, and personal rights of children in care.
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staff sign-in signatures for the training to LPA by close of business on or before POC due date.
LPA email:
jennifer.velasco@dss.ca.gov

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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:Natalie Dunaway
LICENSING EVALUATOR NAME:Jennifer Velasco
LICENSING EVALUATOR SIGNATURE:
DATE: 07/18/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/18/2023


LIC809 (FAS) - (06/04)
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