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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343624430
Report Date: 05/03/2023
Date Signed: 05/03/2023 03:09:50 PM

Document Has Been Signed on 05/03/2023 03:09 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
RIVER CITY (SACTO)CC, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:RISING STAR PRESCHOOLFACILITY NUMBER:
343624430
ADMINISTRATOR:HURTADO, DIANAFACILITY TYPE:
830
ADDRESS:2530 TRACTION AVENUETELEPHONE:
(858) 380-7099
CITY:SACRAMENTOSTATE: CAZIP CODE:
95815
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 3DATE:
05/03/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Rosalinda Chavez-AguilarTIME COMPLETED:
03:30 PM
NARRATIVE
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On May 3rd, 2023, LPA Pascual met with teacher Rosalinda Chavez- Aguilar for the purpose of a complaint investigation. Upon arrival, LPA confirmed a census of three infants in care with one preschool- aged child in care (total of 4 children), co-mingling in the same room, with only one teacher present in the facility.

Further, it was also confirmed that teacher Rosalinda Chavez-Aguilar, does not have an active fingerprint clearance to work within the facility. Rosalinda began working in the facility today, May 3rd, 2023.
LPA toured the facility and found that the telephones were not working properly and therefore a Technical Advisory was given.

Upon review of the children's files, it was also found that a child's file was missing several required documents.

In the areas that were evaluated, deficiencies were cited during today’s inspection on the 809-D. An exit interview was conducted and report was reviewed with the teacher.

A notice of site visit was given and must remain posted for 30 days. Appeal rights were provided.

SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Michelle Pascual
LICENSING EVALUATOR SIGNATURE: DATE: 05/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/03/2023
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVER CITY (SACTO)CC, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME: RISING STAR PRESCHOOL
FACILITY NUMBER: 343624430
VISIT DATE: 05/03/2023
NARRATIVE
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Upon receipt of this report, the Licensee shall post the Notice of Site Visit and any Licensing report documenting a type “A” deficiency. The report and the Notice of Site Visit shall be posted for 30 consecutive days. Failure to maintain posting as required, will result in an immediate $100 civil penalty. A copy of this report shall be provided to the parent/guardian of children currently enrolled by the next business day or immediately upon return.

A copy of this report shall also be provided to the parent/guardian of any newly enrolled children for the next 12 months (1 year). The Acknowledgement of Receipt (LIC 9224 form must be maintained in each child’s file immediately upon receipt from parent. Licensee was provided with a copy of the Acknowledgement of Receipt of Licensing Reports (LIC 9224) Form during this visit.
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Michelle Pascual
LICENSING EVALUATOR SIGNATURE:

DATE: 05/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2023
LIC809 (FAS) - (06/04)
Page: 2 of 4
Document Has Been Signed on 05/03/2023 03:09 PM - It Cannot Be Edited


Created By: Michelle Pascual On 05/03/2023 at 02:20 PM
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: RISING STAR PRESCHOOL
FACILITY NUMBER: 343624430

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/03/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/04/2023
Section Cited
CCR
101170(e)(1)

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All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility: Obtain a California clearance or a criminal record exemption as required by the Department

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Director understands that teacher Rosalinda cannot return to the facility and work until a fingerprint clearance has been granted. Director also stated that the facility will temporarily close until it can be fully staffed. Director will remainin contact with LPA to advise when facility will reopen.
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This was not evidenced by:

LPA verifying that teacher Rosalinda Chavez-Aguilar does not have fingerprint clearances on file for the facility.
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Type A
05/04/2023
Section Cited
CCR101161(a)

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A licensee shall not operate a child care center beyond the conditions and limitations specified on the license, including the capacity limitation.

This was not evidenced by:
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Director will temporarily close while in the process of hiring fully qualified staff that can supervise both the infant and the preschool programs. Director will advise LPA of reopening and remain in contact throughout the process.
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LPA observing three infant children with one preschool child in one room under the care of one teacher.
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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:Keven Peters
LICENSING EVALUATOR NAME:Michelle Pascual
LICENSING EVALUATOR SIGNATURE:
DATE: 05/03/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/03/2023


LIC809 (FAS) - (06/04)
Page: 3 of 4
Document Has Been Signed on 05/03/2023 03:09 PM - It Cannot Be Edited


Created By: Michelle Pascual On 05/03/2023 at 02:46 PM
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: RISING STAR PRESCHOOL
FACILITY NUMBER: 343624430

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/03/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/02/2023
Section Cited
CCR
101221(a)

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A separate, complete and current record for each child is maintained in the child care center.
This was not evidenced by: LPA did not find the infant sleep plan, physicians report or sleep log for a child, maintained by the Director.
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Director is temporarily closing facility until fully staffed. When facility reopens, the Director will provide all required children's documents to LPA for review. Director will remain in contact with LPA throughout the closure process.
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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:Keven Peters
LICENSING EVALUATOR NAME:Michelle Pascual
LICENSING EVALUATOR SIGNATURE:
DATE: 05/03/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/03/2023


LIC809 (FAS) - (06/04)
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