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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343622005
Report Date: 07/12/2022
Date Signed: 07/12/2022 02:05:05 PM

Document Has Been Signed on 07/12/2022 02:05 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:APPLE A DAY PRESCHOOL & INFANTS CTR (INF)FACILITY NUMBER:
343622005
ADMINISTRATOR:FARFAN, LILIYAFACILITY TYPE:
830
ADDRESS:5013 EL CAMINO AVENUETELEPHONE:
(916) 481-5400
CITY:CARMICHAELSTATE: CAZIP CODE:
95608
CAPACITY: 18TOTAL ENROLLED CHILDREN: 18CENSUS: 7DATE:
07/12/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Liliya FarfanTIME COMPLETED:
02:15 PM
NARRATIVE
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At 10:15 a.m. on Tuesday, July 12th, 2022, Licensing Program Analyst (LPA) Karyn Guerra met with Director, Liliya Farfan, for the purpose of an unannounced case management inspection. During inspection, a census was conducted. At 10:23 a.m, Staff 1 (S1), and Staff 2 (S2) were observed supervising 3 infant children indoors. Director was outside on the play yard with 4 toddler children. At 10:24 a.m., Staff 3 (S3) who was previously outside supervising preschool children, came inside to switch places with S2. LPA conducted a staff file review. LPA did not observe ECE units for S1 nor S2.

Title 22 deficiencies are cited on the subsequent pages of this report. Director acknowledges, that FOR TYPE A DEFICIENCIES ONLY upon receipt, licensee shall post LIC 809D with Type A deficiencies for 30 days and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. LIC 9224 must be signed by parents/guardians and kept with the children's forms as a receipt whenever any Type A documents are provided by the licensee. LIC 9224 and Appeal Rights were provided. Director's signature on this report acknowledges receipt of these rights. This report was reviewed with the Director. An exit interview was conducted. A Notice of Site Visit was provided and shall remain posted for a period of 30 days for parental review.
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Karyn Guerra
LICENSING EVALUATOR SIGNATURE: DATE: 07/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/12/2022
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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Document Has Been Signed on 07/12/2022 02:05 PM - It Cannot Be Edited


Created By: Karyn Guerra On 07/12/2022 at 12:38 PM
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: APPLE A DAY PRESCHOOL & INFANTS CTR (INF)
FACILITY NUMBER: 343622005

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/12/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/13/2022
Section Cited
CCR
101416.2(b)

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Infant Teacher Qualifications and Duties (b) Prior to employment, an infant care teacher shall have completed, with passing grades, at least three postsecondary semesters or equivalent quarter units in early childhood education or child development, and three postsecondary semester or equivalent quarter units related to the care of infants, at an accredited or approved college or university. This requirement was not met, as evidenced by:
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S3 came in to switch places with S2. Director will provide schedule to LPA to ensure that there is a qualified teacher with children, by POC due date.
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Based on observation and record review, S1 and S2 were left alone with children in care and do not have ECE units. This poses an immediate risk to the health and safety of children in care.
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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:Seychelle De Luca
LICENSING EVALUATOR NAME:Karyn Guerra
LICENSING EVALUATOR SIGNATURE:
DATE: 07/12/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/12/2022


LIC809 (FAS) - (06/04)
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