343624450-12-28-2022-03-CC-ASUR-CMJQ28-20221228104639

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343624450
Report Date: 12/16/2022
Date Signed: 12/28/2022 10:47:09 AM

Document Has Been Signed on 12/28/2022 10:47 AM - 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:	FOREVER FRIENDS EARLY LEARNING CENTER		FACILITY NUMBER:	343624450
ADMINISTRATOR:	KRYSTAL BARLATT		FACILITY TYPE:	830
ADDRESS:	8245 FERGUSON AVENUE #100		TELEPHONE:	(916) 912-0758
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95828
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 0	DATE:	12/16/2022
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Krystal Barlatt		TIME COMPLETED:	01:15 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analysts (LPAs) Amanda Sutter and Arianna Manabat met with Applicant Krystal Barlatt for the purpose of an announced pre-licensing inspection. Applicant requests an infant license to serve 8 infant children from birth to two years of age. The program will operate Monday through Friday from 7:00 AM to 6:00 PM. The fire clearance was granted on 9/1/2022. 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. LPAs 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. The facility will be providing breakfast and two snacks. Parents will provide formula, breast milk, and baby food for their children. INDOOR ACTIVITY SPACE: There is one infant classroom. LPAs observed a sufficient number of tables, chairs, and cubbies for 8 infants. LPAs observed 4 cribs and 5 napping cots/mats. LPAs observed a variety of age-appropriate toys and equipment. Applicant acknowledges there will be a maximum of 4 infants under 12 months old, due to available cribs. There is a first aid kit in the classroom. Medications will be stored in the office in a locked box. Director stated that cleaning disinfectants will be stored in a locked storage closet adjacent to the infant room, which is inaccessible to children. Applicant stated there are no poisons or firearms on the premises. Director stated that water will be provided to children using pitchers and cups. LPAs observed a functional carbon monoxide detector in the infant sleep area. Director stated the facility will use a paper sign-in/sign-out system. REPORT CONTINUES ON LIC809-C

SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Amanda Sutter
LICENSING EVALUATOR SIGNATURE:	DATE: 12/16/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2022

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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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: FOREVER FRIENDS EARLY LEARNING CENTER	FACILITY NUMBER: 343624450
	VISIT DATE: 12/16/2022

NARRATIVE

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LPAs measured the classroom. The total classroom space contains a total of 461.11 square feet, which will accommodate Applicant's request for 8 infant children. There are 4 toilets and 6 sinks for the children, and a separate private restroom for the staff. LPAs observed a changing table within arm's reach of a sink with a changing pad that is at least one inch thick with raised sides that are at least three inches tall. 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 for infant children. The outdoor play area is fenced with a wrought iron fence that is four feet tall and separates the infant yard from the preschool yards. LPAs observed a variety of age-appropriate outdoor toys and equipment. The play structure does not include a safety label. LPA observed bark beneath the structure and Applicant stated this will be replaced every 3 months to ensure there is enough cushioning material to absorb any falls. There are no bodies of water on the premises. There are shaded areas supplied by trees.

LPA measured the outdoor activity space. The outdoor play area contains a total of 1978.26 square feet, which will accommodate Applicant's request for 8 infant children. Individual measurements are recorded on the Capacity Worksheet (LIC 9024).

The facility's Plan of Operation is located in the preschool file, and an Incidental Medical Services (IMS) policy was provided. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated 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.

REPORT CONTINUES ON LIC809-C

SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Amanda Sutter
LICENSING EVALUATOR SIGNATURE:	DATE: 12/16/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2022

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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: FOREVER FRIENDS EARLY LEARNING CENTER	FACILITY NUMBER: 343624450
	VISIT DATE: 12/16/2022

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LPA 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. LPA 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.

This facility evaluation report was reviewed and discussed with Applicant. Applicant was encouraged to the visit the Department's website at WWW.CDSS.CA.GOV for information regarding child care updates, forms, regulations and legislation pertaining to child care centers.

The following items are required before a license will be issued:

1. Licensing Program Manager’s final file review.
2. Applicant will resubmit LIC999.

SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Amanda Sutter
LICENSING EVALUATOR SIGNATURE:	DATE: 12/16/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2022

LIC809 (FAS) - (06/04)

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