343624983-6-21-2023-03-CC-TWAN-CSZQ2D-20230621114658

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343624983
Report Date: 06/21/2023
Date Signed: 06/21/2023 11:47:04 AM

Document Has Been Signed on 06/21/2023 11:47 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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME:	KIDDY CLUB		FACILITY NUMBER:	343624983
ADMINISTRATOR:	MARLETT REID		FACILITY TYPE:	840
ADDRESS:	2900 29TH AVENUE		TELEPHONE:	(916) 617-7248
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95820
CAPACITY: 12	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	06/21/2023
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Marlett Reid		TIME COMPLETED:	12:30 PM

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Licensing Program Analyst (LPA) Tanya Washington and Application Specialist (AS) Alecia Sifuentes met with Applicant Marlett Reid for the purpose of an announced pre-licensing inspection. Applicant requests a school-age license to serve 12 school-age children from first grade and above. The program will operate Monday- Friday from 6 AM to 5:30 PM, 6 PM- 12 AM, Saturday- Sunday 7 AM - 5:30 PM, 6 PM- 12 AM. The fire clearance was granted by Sacramento City Fire Department on 06/07/2023. The facility will serve AM, PM and evening snacks.

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.

INDOOR ACTIVITY SPACE:
There is one school-age classroom. Licensing Staff observed a sufficient amount of equipment, tables, chairs, and cubbies. There is a first aid kit in the classroom. Medications will be stored in upper cabinet located in the office, if required the medication will be refrigerated. Licensing staff observed cleaning disinfectants are appropriately stored and inaccessible to children. Applicant stated there are no poisons or firearms on the premises. Applicant stated that children will have individual water bottles which will be avaiable in the classroom and for outdoors children will have a jug of water and single use cups. Licensing staff observed functioning carbon monoxide detector in the classroom. Licensing Staff observed a sign-in/sign-out binder in the front, Applicant also stated that she plans to use an electronic sign-in/ sign-out system.

AS measured one classroom. The total classroom space contains a total of 420 square feet, which will accommodate Applicant's request for 12 school-age children. There are 2 toilets and 2 sinks for the children, and a separate private restroom for the staff. Applicant has requested a shared bathroom and playground waiver for the preschool children to use the school age yard and bathroom. 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.

Report continues on LIC809-C.

SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Tanya Washington
LICENSING EVALUATOR SIGNATURE:	DATE: 06/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/21/2023

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: KIDDY CLUB	FACILITY NUMBER: 343624983
	VISIT DATE: 06/21/2023

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OUTDOOR ACTIVITY SPACE:
There is one school-age outdoor area on the property. The outdoor play area is fenced with a wrought iron fence that is at least four feet tall and separates the school-age yard from the preschool and infant yards. Licensing Staff observed a sufficient amount of equipment and toys. There are no bodies of water on the premises. There are shaded areas supplied by trees and canopies.

AS measured the outdoor activity space. The outdoor play area contains a total of 3,056 square feet, which will accommodate Applicant's request for 12 school-age children. Individual measurements are recorded on the Capacity Worksheet (LIC 9024).

APPLICANT KNOWS FACILITY PLANS TO PROVIDE IMS: This facility plans to provide Incidental Medical Services – IMS. For IMS information, see PIN 22-02-CCP. 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

Licensing Staff discussed the following: supervision; personal rights; inspection authority; reporting requirements; staff to children ratios and capacity; staff qualifications; and maintaining buildings and grounds. Licensing Staff 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.

Applicant 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, 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.

Report continues on LIC809-C.

SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Tanya Washington
LICENSING EVALUATOR SIGNATURE:	DATE: 06/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/21/2023

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: KIDDY CLUB	FACILITY NUMBER: 343624983
	VISIT DATE: 06/21/2023

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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. To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

Exit interview conducted and report was reviewed with the applicant, Marlett Reid

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

1. LPM’s final file review

SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Tanya Washington
LICENSING EVALUATOR SIGNATURE:	DATE: 06/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/21/2023

LIC809 (FAS) - (06/04)

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