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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 340318372
Report Date: 05/14/2024
Date Signed: 05/14/2024 11:16:20 AM

Document Has Been Signed on 05/14/2024 11:16 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:CORDOVA MEADOWS ELEMENTARY SCHOOLFACILITY NUMBER:
340318372
ADMINISTRATOR/
DIRECTOR:		JEAN YIMFACILITY TYPE:
850
ADDRESS:2550 LA LOMA DRIVETELEPHONE:
(916) 363-3818
CITY:RANCHO CORDOVASTATE: CAZIP CODE:
95670
CAPACITY: 30TOTAL ENROLLED CHILDREN: 30CENSUS: 21DATE:
05/14/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:15 AM
MET WITH:Jean YimTIME VISIT/
INSPECTION COMPLETED:
11:30 AM
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Licensing Program Analyst Erwina Pascual-Golamco (LPA) met with Facility Representative, Jean Yim (FR), for an unannounced annual inspection of this preschool facility. LPA toured the facility, including all activity and classroom spaces, restrooms, and outdoor play area. Census included 21 children in care with 3 staff. FR was reminded never to exceed the conditions, limitations and capacity specified on the license. Facility hours of operation are 8:00am to 11:00am and an afternoon class from 11:45am to 2:45pm Monday to Friday, and follows the Folsom Unified School District (FCUSD) calendar. The children do not take naps. All staff present had evidence of current criminal background clearances and/or associations through the FCUSD.

FR was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Classrooms observed are in good repair and free of hazards with heating and ventilation for safety and comfort. The facility has equipment and age-appropriate materials for children. Chemicals 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. Uncontaminated drinking water was readily available to children both indoors and outdoors. LPA observed a posted menu. The facility provides breakfast, lunch, and snacks through FCUSD food services and are delivered with minimal food preparation occurring in the classroom.


continued on LIC809-C...
SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Erwina Pascual-Golamco
LICENSING EVALUATOR SIGNATURE: DATE: 05/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/14/2024
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: CORDOVA MEADOWS ELEMENTARY SCHOOL
FACILITY NUMBER: 340318372
VISIT DATE: 05/14/2024
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Bathrooms were sanitary, sinks and toilets were in operating condition. FR stated there are no weapons/firearms on the premises, and LPA did not observe bodies of water on the premises. The facility has at least one functioning smoke detector. LPA observed required licensing documentation was posted for parental review. LPA observed that parents are signing their children in and out of the center.

LPA reviewed with FR the LIC311A, Records to Be Maintained at The Facility, for child's records, personnel records, administrative records, and documents to be posted. Sample of children and staff files were reviewed. Children’s file had the required licensing documentation. LPA reviewed staff transcripts and observed staff caring for children were qualified. At least one staff had a current Pediatric CPR and First Aid certification. Staff have current Mandated Reporter certificates and proof of immunization. LPA observed a current children's roster and a fire drill log. There is First Aid equipment available.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

CCC Testing deadline has not past. Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP). LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP. LPA referred FR to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.

continued on LIC809-C...
SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Erwina Pascual-Golamco
LICENSING EVALUATOR SIGNATURE:

DATE: 05/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2024
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: CORDOVA MEADOWS ELEMENTARY SCHOOL
FACILITY NUMBER: 340318372
VISIT DATE: 05/14/2024
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FR was informed of the https://mychildcareplan.org/; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

No Title 22 Deficiencies observed in the areas that were evaluated. This report was reviewed with FR, and an exit interview was conducted. A Notice of Site Visit (NOS) was provided to FR, who will post it for a period of 30 days for parental review.
SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Erwina Pascual-Golamco
LICENSING EVALUATOR SIGNATURE:

DATE: 05/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2024
LIC809 (FAS) - (06/04)
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