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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343624886
Report Date: 07/27/2023
Date Signed: 07/27/2023 02:31:44 PM

Document Has Been Signed on 07/27/2023 02:31 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:PLAYHOUSE PRESCHOOL AT RESTLIFEFACILITY NUMBER:
343624886
ADMINISTRATOR:AXTELL, DANFACILITY TYPE:
850
ADDRESS:5801 2ND AVENUETELEPHONE:
(916) 247-4205
CITY:SACRAMENTOSTATE: CAZIP CODE:
95817
CAPACITY: 37TOTAL ENROLLED CHILDREN: 37CENSUS: 0DATE:
07/27/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
10:40 AM
MET WITH:Michelle LeeTIME COMPLETED:
02:40 PM
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Licensing Program Analysts Erwina Pascual-Golamco and Jennifer Velasco (LPA) met with Facility Representatives Michelle Lee (L1) and Jessica Goodrich (D1) to conduct an announced pre-licensing inspection of a new facility. Applicant is requesting a preschool license to serve 37 children, of which 25 will be preschool children from age two to entry into kindergarten, and 12 will be toddlers, aged 18-36 months in the toddler option. No children were in care during the prelicensing inspection. The program will operate Monday through Friday from 7:30 AM to 5:30 PM. The fire clearance was granted 04/03/2023.

D1 was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

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. Entrance Checklist was provided to the applicant.

INDOOR ACTIVITY SPACE:
There is a kitchen to support food preparation. Applicant was reminded to ensure that any kitchen items that need to be inaccessible should be made inaccessible to children. Applicant stated parents will provide blankets and linens. Applicant stated parents will be responsible for washing the children's blankets and sheets. LPA observed sufficient age-appropriate equipment, toys, tables, chairs, mats and individual cubbies.
Continued on LIC 809-C.
SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Jennifer Velasco
LICENSING EVALUATOR SIGNATURE: DATE: 07/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/27/2023
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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: PLAYHOUSE PRESCHOOL AT RESTLIFE
FACILITY NUMBER: 343624886
VISIT DATE: 07/27/2023
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Continued from LIC 809.

There is a first aid kit. D1 stated medication is stored in the office and inaccessible to children in care. Director stated there are no firearms or weapon on the premises. Director stated drinking water for outdoor and indoor will be provided via purified water from classroom water tank dispensers. LPA observed a carbon monoxide detector in the facility. LPA observed a sign in and sign out system. D1 stated the facility will provide breakfast, lunch, and morning and afternoon snacks.

The total indoor space contains 1392.26 square feet, which will accommodate the applicant’s request for a license to provide care to 37 children. There are five toilets, one urinal, and four sinks available to children in an out of classroom pair of restrooms not in use during hours of care by anyone else. There is a separate private restroom for the staff. Children who become ill during the day will be isolated in office and will use the staff restroom room, if necessary.

OUTDOOR ACTIVITY SPACE:
There is an outdoor play area, which will be utilized by both the preschool and toddler option children. D1 was advised to request a waiver for staggered use of the playground, with preschool children and toddler children using the playground at different, non-overlapping times. The play space in the courtyard of the center is not currently fenced. D1 was advised to install fencing at least four feet tall to enclose the courtyard. There are shaded areas supplied by overhangs and trees.

The preschool yard contains a total of 3347.88 square feet, which will accommodate the applicant’s request for a license to provide care to 37 children. D1 acknowledge staff must ensure children always use age-appropriate equipment.

LPA reviewed with applicant the LIC 311A, Records To Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted. 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.
Continued on LIC 809-C
SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Jennifer Velasco
LICENSING EVALUATOR SIGNATURE:

DATE: 07/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2023
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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: PLAYHOUSE PRESCHOOL AT RESTLIFE
FACILITY NUMBER: 343624886
VISIT DATE: 07/27/2023
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Continued from LIC 809-C.

LPA advised D1 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.



Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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) or (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
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.

D1 stated the kitchen's two faucets provide the only tap water used in the facility, with that water used for food preparation and cooking. LPA referred D1 to the Department website for lead: Lead Toxicity Prevention and Water Testing Information. To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at
www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process. 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. Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform. D1 was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Continued from LIC-809.
SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Jennifer Velasco
LICENSING EVALUATOR SIGNATURE:

DATE: 07/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2023
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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: PLAYHOUSE PRESCHOOL AT RESTLIFE
FACILITY NUMBER: 343624886
VISIT DATE: 07/27/2023
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Continued from LIC 809-C.

A notice of site visit was given and must remain posted for 30 days.
Exit interview conducted and report was reviewed with the Facility Representatives Michelle Lee and Jessica Goodrich.

The following items are required before a license will be issued:
1. Waiver request for shared use of the playground by preschool and toddler children to be submitted and approved.
2. Sink must be installed within arm's reach of the toddler-room changing table.
3. Both kitchen sinks must be tested for lead in the water per Department specifications.
4. Courtyard playground must be fully fenced with four-foot tall or taller fence.
5. Licensee must update and/or complete the following documents: Admission agreement, director packet, parents handbook, staff handbook, job descriptions, personnel policies, In-service training plan, discipline policies.
6. Updated facility sketches to be submitted.
7. LPM final review and approval.
SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Jennifer Velasco
LICENSING EVALUATOR SIGNATURE:

DATE: 07/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2023
LIC809 (FAS) - (06/04)
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