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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343623182
Report Date: 11/20/2023
Date Signed: 11/20/2023 03:14:45 PM

Document Has Been Signed on 11/20/2023 03:14 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:SETA - BRET HARTE HEAD STARTFACILITY NUMBER:
343623182
ADMINISTRATOR:SAMANTHA XAYAVONGFACILITY TYPE:
850
ADDRESS:2761 NINTH AVENUETELEPHONE:
(916) 263-3800
CITY:SACRAMENTOSTATE: CAZIP CODE:
95818
CAPACITY: 48TOTAL ENROLLED CHILDREN: 48CENSUS: 15DATE:
11/20/2023
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Maegan De HerreraTIME COMPLETED:
03:15 PM
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At 11:15 a.m. on Monday, November 20th, 2023, Licensing Program Analyst (LPA) Pa Dao Vang met with Site Supervisor, Maegan De Herrera for the purpose of an unannounced annual inspection. LPA observed a census of 15 children supervised by 4 staff. Facility hours of operation are from 8:00 a.m. - 5:00 p.m., Monday through Friday.

Site Supervisor 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.


LPA conducted a health and safety inspection of the classrooms, and restroom. LPA observed the following documents are posted: License, Emergency Disaster Plan, Personal Rights, Parents' Rights Poster, Lead Poising information, menus, and daily schedule. Cleaning disinfectants and hazardous items are appropriately stored and inaccessible to children. Director stated that there are no firearms nor poisons on the premises.

Center offers breakfast, lunch, and afternoon snack for children. Other food in the facility was properly stored to prevent contamination in the fridge with proper labels and dates on them. Facility utilizes an electronic sign in and sign out program on a tablet.

All furnishings were in good condition. The changing table area is clean. There is a mat for the changing table with vinyl surface that is at least 1 inch think and has raised sides. Toys are appropriate size and safe for children.

Continue Report on LIC 809-C...

SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Dao Vang
LICENSING EVALUATOR SIGNATURE: DATE: 11/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/20/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
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: SETA - BRET HARTE HEAD START
FACILITY NUMBER: 343623182
VISIT DATE: 11/20/2023
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Facility provides Incidental Medical Services. 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.

LPA conducted a health and safety inspection of the outdoor space. Playground equipment and surfaces were free of loose or sharp parts. Outdoor shade was provided by the tree and buildings. Water is accessible both indoors and outdoors with pitchers and paper cups that’s transitioned with the children.

LPA reviewed staff and children's records. Each child's file contained an admission agreement, emergency card, health history, immunizations, and acknowledgement of receipt of personal rights, consent for emergency medical treatment, and parent’s rights. LPA observed CPR and First aid certification for at least one staff on the facility premises. LPA observed health screening, staff immunization records, current AB 1207 Mandated Reporter training certificates, employee rights, and documentation of the educational background, training, and/or experience.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP). LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.



Site Supervisor was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted, appeal rights, and the report was reviewed with Site Supervisor Maegan De Herrera.

No Title 22 deficiency cited today.

SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Dao Vang
LICENSING EVALUATOR SIGNATURE:

DATE: 11/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2023
LIC809 (FAS) - (06/04)
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