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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343622005
Report Date: 11/02/2022
Date Signed: 11/02/2022 12:10:33 PM

Document Has Been Signed on 11/02/2022 12:10 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:
11/02/2022
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
08:50 AM
MET WITH:Michelle IngramTIME COMPLETED:
12:30 PM
NARRATIVE
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At 8:50 a.m. on Wednesday, November 2nd, 2022, Licensing Program Analyst (LPA) Karyn Guerra met with Director, Michelle Ingram, for the purpose of an unannounced POC inspection. The facility was previously cited on 10/19/2022 regarding indoor activity space and infant changing tables. LPA did not observe preschool children in the infant classroom space. LPA observed vinyl changing pads at changing tables. The deficiencies have been corrected per POC and have been cleared.

During inspection, LPA observed stains on the carpet of the infant classrooms. This poses a potential risk to the health and safety of children in care.

Title 22 deficiencies are cited on the subsequent pages of this report. Appeal rights were provided. This report was reviewed with the Director, Michelle Ingram. A notice of site visit was provided and shall remain posted for 30 days.
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Karyn Guerra
LICENSING EVALUATOR SIGNATURE: DATE: 11/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/02/2022
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 11/02/2022 12:10 PM - It Cannot Be Edited


Created By: Karyn Guerra On 11/02/2022 at 11:02 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: APPLE A DAY PRESCHOOL & INFANTS CTR (INF)
FACILITY NUMBER: 343622005

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/02/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/02/2022
Section Cited
CCR
101438.1(c)(2)

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101438.1 Infant Care General Sanitation (c) Washing, cleaning and sanitizing requirements for areas used by staff with infants, or for areas that infants have access to, are as follows: ...(2) Carpeted floors and large throw rugs that cannot be washed shall be vacuumed at least daily and cleaned at least every six months, or more often if necessary. This requirement was not met, as evidenced by:
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Director will provide proof of documentation of work order or photo evidence by POC due date.
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Based on observation, there were stains on the carpets in the infant facility. This poses a potential 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: 11/02/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/02/2022


LIC809 (FAS) - (06/04)
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