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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343617466
Report Date: 04/24/2023
Date Signed: 04/24/2023 12:38:02 PM

Document Has Been Signed on 04/24/2023 12:38 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:PENLEIGH CHILD DEVELOPMENT CENTERFACILITY NUMBER:
343617466
ADMINISTRATOR:MARIVEL CAMASURAFACILITY TYPE:
830
ADDRESS:1400 E STREET, SUITES D & ETELEPHONE:
(916) 822-5020
CITY:SACRAMENTOSTATE: CAZIP CODE:
95814
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 10DATE:
04/24/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:20 AM
MET WITH:Marivel CamasuraTIME COMPLETED:
12:50 PM
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At 9:20 a.m., on Monday, April 24th, 2023, Licensing Program Analyst (LPA) Karyn Guerra and Licensing Program Manager (LPM) Seychelle De Luca, met with Licensee, Marivel Camasura, for the purpose of a 1 year- required inspection. LPA and LPM observed a census of 7 awake infant children supervised by 3 staff and 3 napping infants supervised by 1 staff. Hours of operation are from 7:00 a.m. – 5:30 p.m., Monday thru Friday.

All individuals subject to criminal background review have obtained criminal record 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.

LPA conducted a health and safety inspection of the classroom, restrooms, and food service areas. LPA observed the following documents are posted: License, Emergency Disaster Plan, Personal Rights, Parents' Rights Poster, car seat laws, menus, and daily schedule. Cleaning disinfectants and hazardous items are appropriately stored and inaccessible to children. Director stated that there are no firearms nor poisons on the premises. LPA observed a changing table within arm's reach of a sink. Changing table has raised sides. Bins for solid waste have tight fitting lids. The floors appeared clean throughout the facility. Infant food is provided by parents/guardians. LPA observed prepared milk bottles labeled with children's names and the current date. Other food in the facility was stored in cabinets but did not prevent contamination. Drinking water is provided to children via labeled sippy cups. Facility utilizes an electronic sign in and sign out system. LPA observed sign in and sign out logs with full legal signature of parent/guardians.

Report continued on 809-C.

SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Karyn Guerra
LICENSING EVALUATOR SIGNATURE: DATE: 04/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/24/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME: PENLEIGH CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 343617466
VISIT DATE: 04/24/2023
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LPA reviewed storage of medications. No infant children in care require incidental medical services. Incidental Medical Services – IMS was discussed. 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.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment. Napping logs and individual infant sleeping plans were observed. LPA discussed getting parent signatures for documentation of infant's ability to roll.

LPA conducted a health and safety inspection of the outdoor space. Playground equipment and surfaces were free of loose parts. Outdoor equipment was exposed to environmental elements. LPA recommended placing outdoor equipment in a bin that has a lid. LPA observed see saw with exposed metal piping. Outdoor shade was provided by shade sails.

LPA reviewed staff and children's records. Each child's file contained an admission agreement, emergency card, health history, immunizations, and acknowledgement of receipt of personal rights, consent for emergency medical treatment, and parent’s rights. LPA observed CPR and First aid certification for at least one staff on the facility premises. LPA observed health screening and employee rights, staff immunization records, current AB 1207 Mandated Reporter training certificates, and documentation of the educational background, training, and/or experience for some staff. Transcripts were needed for infant teacher.

report continued on 809-C.

SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Karyn Guerra
LICENSING EVALUATOR SIGNATURE:

DATE: 04/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2023
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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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME: PENLEIGH CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 343617466
VISIT DATE: 04/24/2023
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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/process.

Title 22 deficiencies are cited on the subsequent pages of this report. Appeal rights were provided. Exit interview conducted and report was reviewed with the Licensee, Marivel Camasura. A notice of site visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Karyn Guerra
LICENSING EVALUATOR SIGNATURE:

DATE: 04/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2023
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Document Has Been Signed on 04/24/2023 12:38 PM - It Cannot Be Edited


Created By: Karyn Guerra On 04/24/2023 at 11:27 AM
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: PENLEIGH CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 343617466

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/24/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101416.2(d)
Infant Care Teacher Qualifications and Duties
(d) A photocopy of each teacher's transcript(s) documenting successful completion of required course work shall be maintained at the center.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above as documentation of enrollment for infant coursework was missing from staff file, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/24/2023
Plan of Correction
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Licensee will provided transcripts to LPA by POC due date.
Type B
Section Cited
CCR
101227(a)(19)
Food Services
(19) All food shall be protected against contamination. Contaminated food shall be discarded immediately.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above as open bags of crackers were observed in cabinets, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/24/2023
Plan of Correction
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Licensee will provide photo documentation of corrections by POC due date.
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:Seychelle De Luca
LICENSING EVALUATOR NAME:Karyn Guerra
LICENSING EVALUATOR SIGNATURE:
DATE: 04/24/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/24/2023


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