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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313622449
Report Date: 12/21/2022
Date Signed: 12/21/2022 01:31:34 PM

Document Has Been Signed on 12/21/2022 01:31 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:A KID'S LIFE (INF)FACILITY NUMBER:
313622449
ADMINISTRATOR:BENEDICT, SUZANNEFACILITY TYPE:
830
ADDRESS:307 SUTTER AVETELEPHONE:
(916) 786-3660
CITY:ROSEVILLESTATE: CAZIP CODE:
95678
CAPACITY: 9TOTAL ENROLLED CHILDREN: 9CENSUS: 6DATE:
12/21/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Suzanne Benedict DirectorTIME COMPLETED:
02:00 PM
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LPA's Owens and Blesi met with Director Suzanne Benedict for the purpose of an announced pre licensing inspection Facility requests a capacity increase on their infant license to serve a total 15 infant children from birth to age two years. The program will operate Monday through Friday from 6:00 AM to 6:00 PM. The fire clearance was granted on 11/9/2022.

Applicant acknowledges that the following documents must be posted at all times: License, Emergency Disaster Plan, Personal Rights, Parents' Rights Poster, car seat law, Effects of Lead Exposure brochure, menus, and daily schedule. LPA discussed the forms that must be in each child's and each staff member's file. The facility will provide morning and afternoon snacks for older infants. Parents will provide lunch for older infants and all food for younger infants.

INDOOR ACTIVITY SPACE:
There is two infant classroom, Room 7 and Room 8. LPA's observed a sufficient amount of equipment, toys, and cubbies. LPA observed seven cribs in classroom 8. There is a first aid kit in infant classroom. LPA's observed cleaning disinfectants and medications are appropriately stored and inaccessible to children. Director stated there are no poisons or firearms on the premises. Director stated the children also have their own sippy cups and the facility will have extras. LPA's observed a functional carbon monoxide detector near the classroom. Director stated the facility will use a paper sign-in/sign-out system.
LPA's discussed the following: 100% supervision is required at all times, including in the bathroom; personal rights; criminal record clearances, inspection authority; reporting requirements; staff to children ratios and capacity; staff qualifications; and maintaining buildings and grounds.

LPA's measured classroom #7 for capacity increase of 6 additional infants. The total classroom space contains a total of 208.992 square feet, which does accommodate Applicant's request for 6 additional infant children. Classroom #7 allows for a maximum of 6 infants. LPA's observed a changing table in the classroom that is within arm's reach of the sink; and has a changing pad that is at least one inch thick with raised sides that are at least three inches tall. Individual measurements are recorded on the Capacity Worksheet (LIC 9024). Children who become ill during the day will be isolated in the office. Continued on next page.

SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Katrina Owens
LICENSING EVALUATOR SIGNATURE: DATE: 12/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/21/2022
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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME: A KID'S LIFE (INF)
FACILITY NUMBER: 313622449
VISIT DATE: 12/21/2022
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OUTDOOR ACTIVITY SPACE:
There is one outdoor play area for infant children. The play space is surrounded by a rod iron fence that is at least four feet tall. There is a shaded area supplied by trees. Director acknowledges staff must ensure children use age-appropriate equipment at all times.

The prior out door play area in report dated 6/15/2018 measured Total = 271 square feet, sufficient outdoor activity space to support a capacity of 4 infants. A waiver has been requested for a alternate use schedule for infant use on the outdoor play area.

Incidental Medical Services (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

LPA's discussed with Applicant any changes that may occur regarding the directors or an employee acting in the director's absence must be reported to department within 10 working days.

This facility evaluation report was reviewed and discussed with Director. Director was encouraged to the visit the Department's website at WWW.CDSS.CA.GOV for information regarding child care updates, forms, regulations and legislation pertaining to child care centers.

This facility evaluation report was reviewed and discussed with Director.


The facility is approved for total of 15 infants; 6 infants in classrooms 7 and 9 infants in classroom #8 (per fire clearance). Pending a final review of the file by Licensing Program Manager (LPM) Keven Peters.
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Katrina Owens
LICENSING EVALUATOR SIGNATURE:

DATE: 12/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2022
LIC809 (FAS) - (06/04)
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