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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343622794
Report Date: 03/11/2024
Date Signed: 03/11/2024 01:19:05 PM

Document Has Been Signed on 03/11/2024 01:19 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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:MUCK AND WONDER FARM SCHOOLFACILITY NUMBER:
343622794
ADMINISTRATOR:MAGGARD, JENNAFACILITY TYPE:
850
ADDRESS:1949 BELL STREETTELEPHONE:
(916) 925-6673
CITY:SACRAMENTOSTATE: CAZIP CODE:
95825
CAPACITY: 39TOTAL ENROLLED CHILDREN: 39CENSUS: 29DATE:
03/11/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:05 PM
MET WITH:Jenna MaggardTIME COMPLETED:
01:35 PM
NARRATIVE
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Licensing Program Analysts (LPAs) Stephanie Piring and Erwina Pascual-Golamco , met with Facility Representative, Jenna Maggard (Director), for a case management visit regarding an incident that occurred on 02/29/24. Purpose of the visit was explained.

The facility representative self reported to the department on 03/01/24 and submitted a written Unusual Incident Report LIC624, on 03/08/24, a child was left in play yard without supervision for approximately 10 minutes, when the children transitioned from outdoor play in the back yard to play in the front yard. During today's inspection, LPA observed the classroom, play yard, and interviewed director. Director stated that head count was done before entering the front yard, but somehow child was able to hide behind a bale of hay. Director stated that staff were spoken to and reviewed procedure for head counts and transitions individually.

Based on observation, documentation, and interview, Title 22 Deficiencies have been issued on the attached LIC 809-D page. The Facility Representative was informed that this report dated 03/11/24 documents one Type A citation and must be posted for parental review for 30 consecutive days. The facility must also provide a copy of this licensing report 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 each child's file for verification.

SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Stephanie Piring
LICENSING EVALUATOR SIGNATURE: DATE: 03/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/11/2024
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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Document Has Been Signed on 03/11/2024 01:19 PM - It Cannot Be Edited


Created By: Stephanie Piring On 03/11/2024 at 12:53 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
, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: MUCK AND WONDER FARM SCHOOL
FACILITY NUMBER: 343622794

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/11/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/12/2024
Section Cited
CCR
101229(a)(1)

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101229 Responsibility for Providing Care and Supervision (a)The licensee shall provide care and supervision as necessary to meet the children's needs. (1) No child(ren) shall be left without the supervision of a teacher at any time...shall include visual observation.
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Director stated that staff were spoken to and reviewed procedure for head counts and transitions individually. Director will email copies of training documentation and staff statements to LPA by 4PM POC due date.
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This requirement is not met as evidenced by: based on observation and interview Facility did not comply with the section cited above as a child was left unsupervised in the play yard, for approximately 10 minutes, which poses an immediate health, safety, or personal rights risk to persons 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:Natalie Dunaway
LICENSING EVALUATOR NAME:Stephanie Piring
LICENSING EVALUATOR SIGNATURE:
DATE: 03/11/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/11/2024


LIC809 (FAS) - (06/04)
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