393621530-1-5-2022-53-CC-CHUR-CADV6T-20220105151004

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 393621530
Report Date: 01/05/2022
Date Signed: 01/05/2022 05:19:12 PM

Document Has Been Signed on 01/05/2022 05:19 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME:	ACADEMY OF LEARNER'S CDC, LLC		FACILITY NUMBER:	393621530
ADMINISTRATOR:	BAUMER, ELLA		FACILITY TYPE:	850
ADDRESS:	18527 EAST HIGHWAY 26		TELEPHONE:	(209) 605-0626
CITY:	LINDEN	STATE: CA	ZIP CODE:	95236
CAPACITY: 30	TOTAL ENROLLED CHILDREN: 30	CENSUS: 6	DATE:	01/05/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Ella Baumer		TIME COMPLETED:	03:30 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) Chayntel Hunter and Katy Maestas met with Director Ella Baumer for the purpose of an unannounced Annual inspection. LPAs toured the facility inside and out. LPAs observed that hazardous items (disinfectants, cleaning solutions etc.) were inaccessible to children in care. Facility days and hours of operation are Monday-Friday from 7:30 AM to 5:30 PM. Facility provides breakfast, lunch and snack. There were six children present during today's inspection. LPAs reviewed staffing ratios, first aid supplies, furniture, equipment, fire drills and drinking water. LPAs observed all required forms to be posted. LPAs observed functioning carbon monoxide and smoke alarms. There are adequate toys and equipment available for children. Outdoor play area was toured. LPAs reviewed the sign in/out book and observed that the children are properly signed in/out. LPA reviewed children’s and staff files. All staff present during today's inspection have a fingerprint clearance. Licensee was reminded that all adults 18 and over, 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. LPAs observed health screening reports with TB test and required MMR and TDAP vaccines. Mandated Reporter training was discussed. The Director was reminded to renew the course every 2 years through www.mandatedreporterca.com website. Report continues on 809-C.

SUPERVISORS NAME: Justin L Denton
LICENSING EVALUATOR NAME: Chayntel Hunter
LICENSING EVALUATOR SIGNATURE:	DATE: 01/05/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/05/2022

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 3

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: ACADEMY OF LEARNER'S CDC, LLC	FACILITY NUMBER: 393621530
	VISIT DATE: 01/05/2022

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
26
27
28
29
30
31
32

LPAs checked that annual fees are current.

This provider is not currently providing Incidental Medical Services (IMS) services to children in care. IMS policy was discussed. 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

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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.

Exit interview conducted and report was reviewed with the licensee. A notice of site visit was provided and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
A type B citation was issued on the subsequent 809D page.

SUPERVISORS NAME: Justin L Denton
LICENSING EVALUATOR NAME: Chayntel Hunter
LICENSING EVALUATOR SIGNATURE:	DATE: 01/05/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/05/2022

LIC809 (FAS) - (06/04)

Page: 3 of 3

Document Has Been Signed on 01/05/2022 05:19 PM - It Cannot Be Edited

Created By: Chayntel Hunter On 01/05/2022 at 02:40 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: ACADEMY OF LEARNER'S CDC, LLC	FACILITY NUMBER: 393621530
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/05/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101216(f)

Personnel Requirements

(f) At least one staff member who is trained in pediatric cardiopulmonary resuscitation and pediatric first aid pursuant to Health and Safety Code Section 1596.866 shall be present when children are at the child care center or offsite for center activities. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observations and records reviewed, Director did not comply with the section cited above, by not providining proof of current CPR/First Aid certification in which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 02/04/2022
	Plan of Correction
1 2 3 4	Director enrolled for a CPR/First Aid course during inspection. Director stated she will try to locate current CPR certification, but will redo certification training if it cannot be located. Director will send CPR/First Aid certification to LPA Maestas at nola.maestas@dss.ca.gov

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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:

Justin L Denton

LICENSING EVALUATOR NAME:

Chayntel Hunter

LICENSING EVALUATOR SIGNATURE:

DATE: 01/05/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/05/2022

LIC809 (FAS) - (06/04)

Page: 2 of 3