343625368-6-24-2024-03-CC-AMAT-D6JP55-20240624110010

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343625368
Report Date: 06/24/2024
Date Signed: 06/24/2024 11:00:18 AM

Document Has Been Signed on 06/24/2024 11:00 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:	SCUSD - CLAYTON B. WIRE PRESCHOOL		FACILITY NUMBER:	343625368
ADMINISTRATOR/ DIRECTOR:	THERESA PEREZ		FACILITY TYPE:	850
ADDRESS:	5100 EL PARAISO AVENUE		TELEPHONE:	(916) 643-7814
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95824
CAPACITY: 24	TOTAL ENROLLED CHILDREN: 24	CENSUS: 0	DATE:	06/24/2024
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:00 AM
MET WITH:	Leila Aurora and Aida Banuelos		TIME VISIT/ INSPECTION COMPLETED:	11:20 AM

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	Centralized Application Bureau (CAB) Licensing Program Analyst (LPA) Arianna Manabat, LPA Amanda Sutter, and Licensing Program Manager Mai Lor met with the Licensee Representative Leila Aurora and Consultant Aida Buelna for the purpose of an announced pre-licensing inspection. Also present during this inspection is Coordinator Doris Reese Director Theresa Perez. Applicant requests to serve 24 preschool children ages two years to entry into kindergarten during the hours of Monday through Thursday from 8:30am - 3:00pm, and Friday from 8:00am-11am. The facility is located on the Clayton B. Wire elementary school campus, and utilizes the classroom modulars CO10 and CO11 on the east side of campus. CO10 is used for the teachers and storage of preschool items while CO11 is used for the preschool program. The label outside of the classroom states "preschool" for the preschool program. Applicant stated they will be requesting for classroom signs to be posted outside of the classrooms. The facility will provide morning, lunch, and afternoon snacks. LPAs 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 classroom inside the facility that will be utilized by the preschool component (classroom CO11). LPAs observed that there are appropriate preschool supplies currently displayed in the classroom. Items that need to have teacher supervision, such as age appropriate scissors, will be stored in the storage cabinets. There is a first aid kit located above the sink area and is not accessible to children in care. Medications will also be stored atop of the cabinet. The Director stated that medications are stored in separate medication boxes with the names on the front on the label. LPAs observed cleaning disinfectants are appropriately stored and inaccessible to children in the cabinet above the sink. The Applicant stated there are no poisons, bodies of water, or firearms on the premises. LPA Manabat discussed the importance of storing any poisons in a locked area with either a combination or a key lock. *Report continues on LIC809-C*

SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Arianna Manabat
LICENSING EVALUATOR SIGNATURE:	DATE: 06/24/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2024

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 4

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: SCUSD - CLAYTON B. WIRE PRESCHOOL	FACILITY NUMBER: 343625368
	VISIT DATE: 06/24/2024

NARRATIVE

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LPAs did not observe a functional carbon monoxide detector in the classroom at the time of inspection but the Licensee Representative stated that she would be locating one or purchasing one for the classroom. The applicant is aware that she will have to purchase a functional carbon monoxide detector. LPAs discussed the sign-in/sign-out sheet system and the applicant stated that this will be using an electronic sign in and sign out system such as using an ipad. There is a stand-alone water fountain inside of the classroom that has been permanently shut off and will not be used by the preschool program.

LPA measured the classroom space during today's visit. The classroom space contains a total of 877.26 square feet, which will accommodate Applicant's request for 24 preschool children. There are 3 toilets and 3 sinks located in the facility. The Licensee Representative stated that there was a separate private restroom for the staff located in the portable adjacent to the preschool portable. Individual measurements are recorded on the Capacity Worksheet (LIC 9024). Children who become ill during the day will be isolated near the south-west corner of the room and will use the staff restroom, if necessary.

OUTDOOR ACTIVITY SPACE:
There is one outdoor area on the property. The outdoor play area is fenced with a combination of a wrought iron fence and a chain linked fence that is at least four feet tall with the exception of the area where the fence separates the indoor and outdoor space. This part of the fence was measured and discussed with the licensee representative. There will be an order placed for a new fence that meets minimum height requirements. LPAs observed tripping hazards from the sewer pipeline and the utility boxes. The licensee representative stated that there was a work order in to level those locations. Measurements were taken for the outdoor space footage.

There is shade provided by trees and overhangs of sides of the building. During today's inspection, LPAs observed a play structure with a label that stated it was appropriate for ages 2-5 years of age with enough substrate under to cushion a fall. Water is being provided via filtered water jugs and cups that can be refilled by the water fountains indoors. There are sufficient amount of equipment and toys and they are stored in the shed that is present outside. The Licensee Representative stated that the shed remains locked throughout the day and that staff will have access to the key. The key is being stored inaccessible to children in care.
Report continues on LIC809-C.

SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Arianna Manabat
LICENSING EVALUATOR SIGNATURE:	DATE: 06/24/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2024

LIC809 (FAS) - (06/04)

Page: 2 of 4

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: SCUSD - CLAYTON B. WIRE PRESCHOOL	FACILITY NUMBER: 343625368
	VISIT DATE: 06/24/2024

NARRATIVE

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LPA measured the outdoor activity space. The outdoor play area contains a total of 8028.97 square feet, which will accommodate 24 requested children. Individual measurements are recorded on the Capacity Worksheet (LIC 9024).

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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

LPAs discussed the following: 100% supervision is required at all times, including in the bathroom; personal rights; inspection authority; reporting requirements; staff to children ratios and capacity; staff qualifications; and maintaining buildings and grounds. LPAs 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, 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 was informed of the MyChildCarePlan.org site, 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
Report continues on LIC809-C

SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Arianna Manabat
LICENSING EVALUATOR SIGNATURE:	DATE: 06/24/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2024

LIC809 (FAS) - (06/04)

Page: 3 of 4

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: SCUSD - CLAYTON B. WIRE PRESCHOOL	FACILITY NUMBER: 343625368
	VISIT DATE: 06/24/2024

NARRATIVE

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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.

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)

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

1. A functioning carbon monoxide detector
2. Proof of a fence that meets regulations
3. Proof of leveling the outdoor area or ensuring the tripping hazards have been addressed.
4. Manager Review by LPM Mai Lor.

Exit interview conducted and report was reviewed with the Licensee Representative Aida Buelna.

SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Arianna Manabat
LICENSING EVALUATOR SIGNATURE:	DATE: 06/24/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2024

LIC809 (FAS) - (06/04)

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