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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343624002
Report Date: 09/17/2021
Date Signed: 09/17/2021 02:01:09 PM

Document Has Been Signed on 09/17/2021 02:01 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:VILLAGE EARLY LEARNING CENTERFACILITY NUMBER:
343624002
ADMINISTRATOR:RAINEAR, TOMIKAFACILITY TYPE:
830
ADDRESS:6845 LARCHMONT DRTELEPHONE:
(916) 566-3485
CITY:NORTH HIGHLANDSSTATE: CAZIP CODE:
95660
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
09/17/2021
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Tabitha ThompsonTIME COMPLETED:
02:20 PM
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Application Specialist (AS) Mai Lor and Licensing Program Analyst Tanya Washington met with Applicant Tabitha Thompson for the purpose of an announced pre-licensing inspection. Applicant requests an infant license to serve 4 infant children from 12 months to 24 months and 4 toddlers age 18 months to 36 months under the Toddler Option Program. The facility is located on Village Elementary school school in portables #1 and #2. These are adjoining classrooms. The program will operate Monday through Friday from 8:00 AM to 2:30 PM. The fire clearance was granted on 08/26/21.

Applicant acknowledges that the following documents must be posted at all times: License, Emergency Disaster Plan, Personal Rights, Parents' Rights Poster, Effects of Lead Exposure, car seat poster, menus, and daily schedule. AS and LPA provided and discussed LIC311A and the forms that must be in each child's and each staff member's file. Applicant stated the Needs and Services plans will be kept in the classrooms. Parents will provide all formula, milk, and food for children under 1 and program provides snacks for children 1-2 years old and the facility will provide breakfast, lunch and pm snacks for infants who are on solid.

INDOOR ACTIVITY SPACE:
There is one infant classroom: Classroom #1. AS and LPA observed a sufficient number of tables, chairs, and cubbies for 8 infants. Applicant will not have a napping area due to the age the applicant will be serving. Applicant will submit a waiver request indicating the above. AS and LPA observed sufficient napping cots/mats. AS and LPA observed a variety of age-appropriate toys and equipment. There is a first aid kit in the classrooms. Medications will be stored in the cabinets and inaccessible to children. AS and LPA observed cleaning disinfectants are appropriately stored and inaccessible to children. Applicant stated there are no poisons or firearms on the premises. Applicant stated drinking water for indoor and outdoor will be provided via water dispenser. AS and LPA observed a functional carbon monoxide detector in the classroom. AS and LPA observed an electronic sign-in/sign-out system.
(Report continues on subsequent LIC 809)
SUPERVISORS NAME: Roxana Saravia
LICENSING EVALUATOR NAME: Mai Lor
LICENSING EVALUATOR SIGNATURE: DATE: 09/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/17/2021
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 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME: VILLAGE EARLY LEARNING CENTER
FACILITY NUMBER: 343624002
VISIT DATE: 09/17/2021
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AS and LPA measured the classroom. The total classroom space contains a total of 599.9158 square feet, which will accommodate Applicant's requested capacity for 4 infant children and 4 toddlers under the Toddler Option Program. There are three toilets and five sinks available to children, and a separate staff restroom is available. Individual measurements are recorded on the Capacity Worksheet (LIC 9024). AS and LPA observed a changing table with a changing pad that is at least one inch think with raised sides that are at least three inches tall. This changing table will be used for the Toddler Option Program. Applicant stated she will be purchasing a second changing table for the infants. Individual measurements are recorded on the Capacity Worksheet (LIC 9024). Children who become ill during the day will be isolated in the office area and will use the staff restroom, if necessary.

OUTDOOR ACTIVITY SPACE:
There is one outdoor area on the property designated for preschool and infant children. The outdoor play area is fenced with a chained link fence that is four feet tall. AS and LPA observed a variety of age-appropriate outdoor toys and equipment. There is a play structure that is designated for children ages 2 to 5. Applicant was reminded to follow the safety label and staff will provide supervision to ensure children under the age of 2 will not be using the play structure. Applicant submitted a waiver request to utilize the outdoor space among the preschool, infant and toddler children. Applicant shall follow the rotated schedule previously submitted. AS and LPA observed pour and play used as cushioned. The playground is shaded by a shade structure.

AS and LPA measured the outdoor activity space. The outdoor play area contains a total of 4916.804 square feet, which will accommodate the applicant's requested capacity of 4 infants and 4 toddlers under the Toddler Option Program.

AS discussed the following: 100% supervision is required at all times; personal rights; inspection authority; reporting requirements; staff to children ratios and capacity; staff qualifications; and maintaining buildings and grounds. AS discussed with Applicant any changes that may occur regarding the director or an employee acting in the director's absence must be reported to department within 10 working days.

AS emailed Effects of Lead Exposure brochure and Provider Notice Information (PIN) 21-21 (Release of the Written Directives for Lead Testing of Water in Licensed Child Care Centers per AB 2370), and immunization card. AS and LPA reviewed lead testing requirement and COVID-19 technical assistance with the applicant.



(Report continues on subsequent LIC 809)
SUPERVISORS NAME: Roxana Saravia
LICENSING EVALUATOR NAME: Mai Lor
LICENSING EVALUATOR SIGNATURE:

DATE: 09/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2021
LIC809 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME: VILLAGE EARLY LEARNING CENTER
FACILITY NUMBER: 343624002
VISIT DATE: 09/17/2021
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This facility plans to provide Incidental Medical Services - IMS. For IMS information, see Evaluator Manuel - Regulation Interpretations and Procedures for Child Care Centers Section 101173 and 101226. A Plan of Operation that includes IMS must be submitted to the Department. 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 discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage athttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.


Licensee 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.

Licensee was encouraged to visit the Department website at WWW.CCLD.CA.GOV for child care updates, current forms, legislation and regulation information. A copy of this report will remain on file for a period of three years for public review upon request.

Prior to licensure, the following items must be corrected:

1. Partitions for the infant classroom
2. Second changing table for the infants
3. Director Verifications (preventative health and safety training, LIC 508 (page 2), mandated reporter training)
4. Licensing Program Manager's final review
Exit interview conducted and report was reviewed with the Applicant, Tabitha Thompson..
SUPERVISORS NAME: Roxana Saravia
LICENSING EVALUATOR NAME: Mai Lor
LICENSING EVALUATOR SIGNATURE:

DATE: 09/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2021
LIC809 (FAS) - (06/04)
Page: 3 of 3