343615667-3-18-2024-03-CC-TWAN-D3CSU7-20240314141040

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343615667
Report Date: 03/14/2024
Date Signed: 03/18/2024 08:28:18 AM

Document Has Been Signed on 03/18/2024 08:28 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:	MADISON ELEMENTARY SCHOOL		FACILITY NUMBER:	343615667
ADMINISTRATOR:	MADDERRA, KERIANN		FACILITY TYPE:	850
ADDRESS:	5241 HARRISON STREET		TELEPHONE:	(916) 566-1900
CITY:	NORTH HIGHLANDS	STATE: CA	ZIP CODE:	95660
CAPACITY: 48	TOTAL ENROLLED CHILDREN: 24	CENSUS: 22	DATE:	03/14/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	12:45 PM
MET WITH:	Tonya Randolph		TIME COMPLETED:	02:30 PM

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On, Thursday, March 14, 2024, at 12:40 PM, Licensing Program Analyst (LPA) Tanya Washington met with Facility Representative (FR), Tonya Randolph for the purpose of an unannounced annual/random inspection. Upon arrival, LPA observed care and supervision of 22 napping children supervised by two staff in classroom #3. Approximately at 1:30 PM, ECE District Site Supervisor Fong Khamnivong arrived to the facility with staff files and to assist LPA with the remainder of the inspection. The facility hours of operation are Monday through Friday from 7:00 AM to 5:00 PM. The facility does not offer transportation services. Facility provides breakfast, lunch, one afternoon snack and supper. During today's inspection, LPA did not inspect classroom #2 as it is occupied by a kindergarten class which is part of the elementary school. Facility Representative stated that classroom #2 is occasionally used in the afternoons for closer bathroom access and during school breaks.

LPA toured classroom #3, restroom, and outdoor play area. Preschool children share the restroom with the elementary school students. Children are escorted by staff to and from the restroom. Preschool children also share playground with the elementary school children. There is a schedule in place for the playground use so children are never commingled. LPA observed a newly installed play structure with sufficient cushioning. The safety label states that the playground is safe for children ages 2-5 years old. LPA observed the following documents are posted: License, Emergency Disaster Plan, Earthquake Preparedness, Personal Rights, Parents' Rights Poster, menu, and seat belt law. Cleaning disinfectants and hazardous items are appropriately stored and inaccessible to children. Facility Representative stated there are no poisons or firearms on the premises. Furniture and equipment are in good condition, and toileting facilities are in safe, sanitary and operating condition.

LPA observed trash bins with tight fitted lids. Drinking water is readily available to children both indoors and outdoors. Children utilize a drinking water fountain outdoors. The fountain is properly functioning. Facility utilizes electronic sign in and out system called Learning Geanie. Facility has record of conducting fire drills at least every six months; last fire drill was conducted 03/14/2024. Playground equipment and surfaces are free of loose or sharp parts. There is sufficient equipment and toys, and there are shaded areas supplied by building awning and trees.

PAGE 1. REPORT CONTINUES ON LIC809-C

SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Tanya Washington
LICENSING EVALUATOR SIGNATURE:	DATE: 03/14/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2024

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: MADISON ELEMENTARY SCHOOL	FACILITY NUMBER: 343615667
	VISIT DATE: 03/14/2024

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Two staff and five children's records were reviewed. Both children and staff files were observed to be complete. There is at least one staff member present with a current CPR certificate. LPA observed a functional carbon monoxide detector.

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 childcare 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.

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 PIN 22-02-CCP. 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-carecenters/.

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.

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.

LPA informed the Facility Representative of the recent regional office relocation and provided updated personal and parent's rights forms and postings.

PAGE 2. REPORT CONTINUES ON LIC809-C

SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Tanya Washington
LICENSING EVALUATOR SIGNATURE:	DATE: 03/14/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2024

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: MADISON ELEMENTARY SCHOOL	FACILITY NUMBER: 343615667
	VISIT DATE: 03/14/2024

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FR was informed of the www.mychildcareplan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

During today’s inspection no deficiencies were observed. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with ECE District Site Supervisor, Fong Khamnivong.

SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Tanya Washington
LICENSING EVALUATOR SIGNATURE:	DATE: 03/14/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2024

LIC809 (FAS) - (06/04)

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