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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 394500620
Report Date: 05/23/2024
Date Signed: 05/23/2024 02:02:18 PM

Document Has Been Signed on 05/23/2024 02:02 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 S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:ACADEMY OF LEARNERS CDC, LLCFACILITY NUMBER:
394500620
ADMINISTRATOR/
DIRECTOR:		ELLA TEMPLE BAUMERFACILITY TYPE:
850
ADDRESS:19047 MAIN STREETTELEPHONE:
(209) 605-0626
CITY:LINDENSTATE: CAZIP CODE:
95236
CAPACITY: 30TOTAL ENROLLED CHILDREN: 30CENSUS: 11DATE:
05/23/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Ella Temple BaumerTIME VISIT/
INSPECTION COMPLETED:
02:30 PM
NARRATIVE
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On 05/23/2024, Licensing Program Analyst Katy Velazquez (LPA) conducted a field visit to the facility and conducted a case management inspection. LPA arrived at the center and was met by Owner/Director Ella Temple Baumer (D1). LPA disclosed the purpose of the inspection and was granted entrance into the facility. LPA conducted a tour of the facility and observed 11 preschool aged children being supervised by D1. LPA determined, through accessing Guardian, that all required adults were background cleared and associated to the license. LPA observed a lack of supervision. LPA observed a child in the bathroom alone (two different times) who was not within the line of sight of D1. LPA observed a child wondering to the parent entrance who was not within the line of sight of D1. Due to a lack of supervision during play time, LPA observed children crying and arguing. LPA observed children climbing furniture and removing push pins from the wall to play with. D1 stated that she was the only individual working from opening at 7:00 am until closing at 4:30 pm. LPA suggested that another staff member be called in for assistance and D1 agreed.
LPA observed a food menu from December 2023 posted for parent view. LPA observed several foods, including Taco Bell, served to children in care.
The lack of supervision posed an immediate risk to the health and safety of children in care. As a result, a Type-A deficiency was cited on a subsequent 809-D page. Additionally, the lack of a current menu for parents to review poses a potential health and safety risk to children in care. As a result, a Type-B deficiency was cited on a subsequent 809-D page. D1 understands that all parents or authorized representatives of currently enrolled children must sign the LIC 9224 form and be available to the Department for review. D1 understands that parents or authorized representatives of children enrolling for up to one year must sign the LIC 9224 form and be available to the Department for review. D1 acknowledged that FOR TYPE A DEFICIENCIES ONLY upon receipt, licensee shall post LIC 809-D with Type A deficiencies for 30 days.

An exit interview was conducted, and the report was reviewed with Director Baumer. LPA provided Licensee Appeal Rights to D1. A Notice of Site visit was posted by LPA and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Karyn Guerra
LICENSING EVALUATOR NAME: Katy Velazquez
LICENSING EVALUATOR SIGNATURE: DATE: 05/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/23/2024
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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Document Has Been Signed on 05/23/2024 02:02 PM - It Cannot Be Edited


Created By: Katy Velazquez On 05/23/2024 at 12:03 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
, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: ACADEMY OF LEARNERS CDC, LLC
FACILITY NUMBER: 394500620

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/23/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/24/2024
Section Cited
CCR
101229(a)(1)

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Responsibility for Providing Care and Supervision (a) The licensee shall provide care and supervision as necessary to meet the children's needs. (1) No child(ren) shall be left without the supervision of a teacher at any time... Supervision shall include visual
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Director Baumer (D1) will purchase and install 2 babygates to barricade the bathroom and parent entry (creating a classroom that can be visually observed). D1 will employ an Aide to break her daily for lunch or will utilize a Substitue Agency to break her daily.
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observation.
This requirement was not met as evidenced by LPA observing a child alone in the bathroom (twice) and a child wondering away from the group to the parents entrance, both chil dren lacked visual observation from Director Baumer.
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D1 will email a signed statement to LPA by 5 pm on 05/24/2024 which describes her staffing plan to enure supervision.

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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:Karyn Guerra
LICENSING EVALUATOR NAME:Katy Velazquez
LICENSING EVALUATOR SIGNATURE:
DATE: 05/23/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/23/2024


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 05/23/2024 02:02 PM - It Cannot Be Edited


Created By: Katy Velazquez On 05/23/2024 at 12:16 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
, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: ACADEMY OF LEARNERS CDC, LLC
FACILITY NUMBER: 394500620

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/23/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/30/2024
Section Cited
CCR
101227(6)

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Food Services (6) Menus shall be in writing and shall be posted at least one week in advance in an area accessible for review by the child's authorized representative. Copies of the menus as served shall be dated and kept on file for at least 30 days. Menus shall be made
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Director Baumer (D1) will create monthly menus for the food and drinks served to children in care. D1 will email LPA the first menu by 5 pm on 05/30/2024.
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available for review by the child's authorized representative and the Department upon request.
This requirement was not met as evidenced by LPA observing a menu from December 2023 posted for parent review. LPA observed food served to children.
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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:Karyn Guerra
LICENSING EVALUATOR NAME:Katy Velazquez
LICENSING EVALUATOR SIGNATURE:
DATE: 05/23/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/23/2024


LIC809 (FAS) - (06/04)
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