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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 340300156
Report Date: 10/03/2022
Date Signed: 10/03/2022 02:35:50 PM

Document Has Been Signed on 10/03/2022 02:35 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
RIVER CITY (SACTO)CC, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:CORDOVA BAPTIST PRESCHOOLFACILITY NUMBER:
340300156
ADMINISTRATOR:HUPPERT, CARRIEFACILITY TYPE:
850
ADDRESS:10527 COLOMA ROADTELEPHONE:
(916) 638-5506
CITY:RANCHO CORDOVASTATE: CAZIP CODE:
95670
CAPACITY: 87TOTAL ENROLLED CHILDREN: 87CENSUS: 14DATE:
10/03/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Carrie HuppertTIME COMPLETED:
01:45 PM
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On Monday, 10/03/2022, Licensing Program Analyst Jennifer Velasco (LPA) met with Facility Representative Carrie Huppert for an unannounced annual inspection. At 11:50 AM, LPA toured the facility including all activity and classroom spaces, restrooms, and outdoor play areas. Census included 14 children in care with three staff. Facility Representative was reminded never to exceed the conditions, limitations and capacity specified on the license. The facility operates Monday through Friday from 7:00 AM to 5:30 PM.

Facility Representative 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.

The classroom appeared clean including the carpets and floor. Chemicals and cleaning materials were kept inaccessible to children. Playground equipment and surfaces were inspected and are in good condition with enough resilient material under climbing structures to absorb a fall. There are no firearms or bodies of water on the premises and the facility has at least one functioning smoke and carbon monoxide detector. LPA observed the appropriate postings were visible to parents and children were signed in and out of the center. LPA observed children had individual water bottles inside and outside the classroom. Children bring lunch from home and snacks are provided by the school.

At 12:40 PM, all present staff files were reviewed. LPA reviewed staff transcripts and observed all staff being utilized as teachers were qualified. LPA observed a current Mandated Reporter certificate for each staff and Representative was reminded the certificate must be renewed every two years. LPA observed proof of immunizations for the staff and all required documentation was present in the files. At least one staff had a current Pediatric CPR and First Aid certification that expires 2023. LPA observed a sample of children's files and observed all required documentation was present in each file.
SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Jennifer Velasco
LICENSING EVALUATOR SIGNATURE: DATE: 10/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/03/2022
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
RIVER CITY (SACTO)CC, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME: CORDOVA BAPTIST PRESCHOOL
FACILITY NUMBER: 340300156
VISIT DATE: 10/03/2022
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All Child Care Centers (CCCs) that are located in buildings constructed before January 1, 2010 must have their drinking water tested for lead and post the results by January 1, 2023 and every 5 years after the date of the initial test. For a license issued on or after July 1, 2022, the CCC must have its water tested and post the results within 180 days of licensure.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. 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

Facility Representative was encouraged to the visit the Department's website at WWW.CCLD.CA.GOV for information regarding child care updates, PINs, forms, regulations and legislation pertaining to child care centers.

No citations were issued based on today’s annual inspection. Exit interview was conducted and report was reviewed with the Facility Representative. A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Jennifer Velasco
LICENSING EVALUATOR SIGNATURE:

DATE: 10/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2022
LIC809 (FAS) - (06/04)
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