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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 340306413
Report Date: 07/21/2022
Date Signed: 07/21/2022 10:13:37 AM

Document Has Been Signed on 07/21/2022 10:13 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:B.J. JORDAN CHILD CARE PROGRAMS - NORTH HIGHLANDSFACILITY NUMBER:
340306413
ADMINISTRATOR:HEER, HARPEETFACILITY TYPE:
850
ADDRESS:3735 STEPHEN DRIVETELEPHONE:
(916) 331-0301
CITY:NORTH HIGHLANDSSTATE: CAZIP CODE:
95660
CAPACITY: 54TOTAL ENROLLED CHILDREN: 54CENSUS: 14DATE:
07/21/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Karen HammondTIME COMPLETED:
10:30 AM
NARRATIVE
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At approximately 8:30 AM. on Thursday, July 21, 2022, Licensing Program Analyst (LPA) Amanda Blesi met with Director, Harpreet Heer for the purpose of an unannounced case management inspection. The purpose of the inspection is to address an Unusual Incident which occurred on July 13, 2022. There were 14 children upon arrival supervised by six staff. Ms. Heer was called into a parent meeting during the inspection, therefore, Center's Manager Karen Hamman was called and arrived to the facility around 9:30 AM to assist with the inspection.

The facility self-reported an incident that occurred on July 13, 2022. Ms. Hamman states child #1 who is highly allergic to diary, consumed milk when he should have had soy milk. The facility puts small pitchers of milk on the table and child #1’s milk is usually labelled as soy milk with a red cap. On this day, regular milk was in the pitcher with the red cap instead of soy milk and the child accidentally drank milk. Staff immediately administered an epi-pen and 911 was called. Paramedics arrived and the child's vitals were checked. It was determined the child did not have any other symptoms and was told it was okay to go home with parent.

A prior incident occurred on July 1, 2022 when child #1 was served fish sticks containing dairy. Child #1 did not consume the fish sticks but experienced an allergic reaction after touching the food. This is a second citation for the same violation within a 12 month period. Civil penalties are assessed in the amount of $1,000.00.

See the attached LIC809-D for Title 22 Deficiencies and LIC 421 C for Civil Penalty assessment.

Report is continued on the following page. (See LIC 809-C)
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Amanda Blesi
LICENSING EVALUATOR SIGNATURE: DATE: 07/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/21/2022
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: B.J. JORDAN CHILD CARE PROGRAMS - NORTH HIGHLANDS
FACILITY NUMBER: 340306413
VISIT DATE: 07/21/2022
NARRATIVE
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LPA Amanda Blesi informed facility representative Karen Hamman that this report dated 7/21/22 document(s) one Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPA Amanda Blesi informed the facility representative to provide a copy of this licensing report dated 7/21/22 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

Exit interview conducted and report was reviewed with the facility representative Karen Hamman.

A notice of site visit was given and must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Amanda Blesi
LICENSING EVALUATOR SIGNATURE:

DATE: 07/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2022
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 07/21/2022 10:13 AM - It Cannot Be Edited


Created By: Amanda Blesi On 07/21/2022 at 09:12 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: B.J. JORDAN CHILD CARE PROGRAMS - NORTH HIGHLANDS
FACILITY NUMBER: 340306413

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/21/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/22/2022
Section Cited
CCR
101223(a)(2)

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Personal Rights: he licensee shall ensure that each child is accorded the following personal rights:
2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs.
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Ms. Hamman states from now on child #1 will bring in their own food from home each day. The facility has purchased a separate set of dishes for the child and as the food is brought in to the center, it is placed on the child's plate and wrapped in saran wrap separate from the other children's food. They will have two staff verify the food is going to the correct child before it is served. In addition they will no longer use red caps for children who require soy milk and instead will set the entire container of soy milk on the table. Deficiency corrected during the inspection.
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This requirement was not met as evidenced by: Child #1, who is allergic to dairy, was served a cup of milk. An epi pen was administered and paramedics were called. This is an immediate risk to the health and safety of children in care. This is a repeat violation. Civil penalties assessed in the amount of $1,000.00.
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A copy of this report and a LIC 9224 must signed by parents of all children enrolled and newly enrolled children for the next 12 months. A blank LIC9224 was provided during visit.

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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:Keven Peters
LICENSING EVALUATOR NAME:Amanda Blesi
LICENSING EVALUATOR SIGNATURE:
DATE: 07/21/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/21/2022


LIC809 (FAS) - (06/04)
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