313625149-9-7-2023-03-CC-KOWS-CVFMFA-20230907093357

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 313625149
Report Date: 09/07/2023
Date Signed: 09/07/2023 09:34:03 AM

Document Has Been Signed on 09/07/2023 09:34 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:	ADVENTURE CLUB - WESTBROOK		FACILITY NUMBER:	313625149
ADMINISTRATOR:	ADVENTURE CLUB - WESTBROOK		FACILITY TYPE:	840
ADDRESS:	4501 SOLAIRE DRIVE		TELEPHONE:	(916) 774-5169
CITY:	ROSEVILLE	STATE: CA	ZIP CODE:	95747
CAPACITY: 60	TOTAL ENROLLED CHILDREN: 60	CENSUS: 0	DATE:	09/07/2023
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Melanie Nett- Supervisor Dylan Davis -Supervisor		TIME COMPLETED:	09:45 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	Licensing Program Analyst (LPA) Katrina Owens met with Melanie Nett and Dylan Davis, Supervisors and Rachel Cleveland, Child Care Site Coordinator, and Chantal Udasco, Supervisor for the purpose of an announced pre-licensing. The program requests a school-age license to serve 60 school-age children enrolled in kindergarten and above. The program will operate Monday through Friday from 6:30 AM to 6:00 PM. LPA received the school’s fire clearance on 7/3/2023. The facility is located at Westbrook Elementary School campus. Supervisor acknowledges that the following documents must be posted at all times: License, Emergency Disaster Plan, Personal Rights, Parents' Rights Poster, menus, and daily schedule. LPA discussed the forms that must be in each child's and each staff member's file. The facility will be providing an afternoon snacks. INDOOR ACTIVITY SPACE: Supervisor requests to use two portables. The multipurpose room will not be used at this location. LPA observed a sufficient amount of equipment, tables, and chairs. There is a first aid kit and medications will be stored in the classroom in an inaccessible area. LPA observed cleaning disinfectants are appropriately stored and inaccessible to children. Supervisor stated there are no poisons or firearms on the premises. LPA observed water fountains in the classrooms. LPA observed a paper sign-in/sign-out system. Report continues on 809-C.

SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Katrina Owens
LICENSING EVALUATOR SIGNATURE:	DATE: 09/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/07/2023

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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: ADVENTURE CLUB - WESTBROOK	FACILITY NUMBER: 313625149
	VISIT DATE: 09/07/2023

NARRATIVE

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Prior to today’s inspection, Supervisor sent LPA a signed letter from Superintendent. The letter states that the classrooms in the portable are of sufficient size to accommodate 60 school-age children. Per Health and Safety Code 1596.806, the facility is exempt from square footage requirement; therefore, LPA did not take measurements. The children will use the school’s restrooms, and a separate private restroom for the staff. Children who become ill during the day will be isolated in the office and will use the staff restroom, if necessary.

OUTDOOR ACTIVITY SPACE:
There is one outdoor area on the property. There is a climbing structure that Supervisor states is anchored into the ground. LPA observed a sufficient amount of equipment and toys. There are no bodies of water on the premises. There are shaded areas supplied by awnings.

The facility's Plan of Operation is located in the Administrative file. 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 discussed the following: supervision; personal rights; inspection authority; reporting requirements; staff to children ratios and capacity; staff qualifications; and maintaining buildings and grounds. LPA discussed with Supervisor 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.

Report continues on 809-C.

SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Katrina Owens
LICENSING EVALUATOR SIGNATURE:	DATE: 09/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/07/2023

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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: ADVENTURE CLUB - WESTBROOK	FACILITY NUMBER: 313625149
	VISIT DATE: 09/07/2023

NARRATIVE

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This facility evaluation report was reviewed and discussed with Supervisor. Supervisor 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.

LPA Owens discussed the report with Supervisors at time of inspection.

CONDITIONS REQUIRING CORRECTION PRIOR TO ISSUING A LICENSE:

1. Submit a waiver request for all criminal record clearances to be associated to Adventure Club - Fiddyment Farm #313617646.

2. 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: 09/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/07/2023

LIC809 (FAS) - (06/04)

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