343623893-4-6-2021-03-CC-SDLA-BZTMMZ-20210406094447

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343623893
Report Date: 04/06/2021
Date Signed: 04/06/2021 09:44:54 AM

Document Has Been Signed on 04/06/2021 09:44 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME:	BUILDING KIDZ OF CITRUS HEIGHTS		FACILITY NUMBER:	343623893
ADMINISTRATOR:	LYSANDREA JACKSON		FACILITY TYPE:	850
ADDRESS:	8073 GREENBACK LN		TELEPHONE:	(916) 735-3165
CITY:	CITRUS HEIGHTS	STATE: CA	ZIP CODE:	95610
CAPACITY: 40	TOTAL ENROLLED CHILDREN: 0	CENSUS: 5	DATE:	04/06/2021
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Mercedes Ishida		TIME COMPLETED:	09:30 AM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Application Specialist (AS) Seychelle De Luca met with Applicant Mercy Ishida for the purpose of an announced prelicensing change of ownership tele-inspection (due to COVID-19). This is a change of ownership from Building Kidz - Greenback (#343622693). Applicant requests a preschool license to serve 40 preschool children from age two to entry into first grade. The program will operate Monday through Friday from 7:00 AM to 6:00 PM. The fire clearance was granted on 3/23/2021. Applicant acknowledges that the following documents must be posted at all times: License, Emergency Disaster Plan, Personal Rights, Parents' Rights Poster, car seat law, menus, and daily schedule. AS observed all documents are posted, except License and waiver. AS discussed the forms that must be in each child's and each staff member's file. The facility will be providing morning snack, lunch, and afternoon snack. INDOOR ACTIVITY SPACE: The facility has one preschool classroom. AS observed a sufficient amount of equipment, toys, tables, chairs, cubbies, and napping mats. There are several first aid kits in the classroom. Medications will be stored in a filing cabinet near the office area. AS observed cleaning disinfectants are appropriately stored and inaccessible to children. Applicant stated there are no poisons or firearms on the premises. Applicant stated children bring their own water bottles. Applicant stated there are extra cups available. AS observed a functional carbon monoxide detector in the classroom. AS observed an electronic sign-in/sign-out system. Report continues on 809-C.

SUPERVISORS NAME: Roxana Saravia
LICENSING EVALUATOR NAME: Seychelle De Luca
LICENSING EVALUATOR SIGNATURE:	DATE: 04/06/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/06/2021

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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: BUILDING KIDZ OF CITRUS HEIGHTS	FACILITY NUMBER: 343623893
	VISIT DATE: 04/06/2021

NARRATIVE

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Applicant measured the classrooms; and AS walked her through the process. The classrooms contain a total of 1689.462 square feet, which accommodates the request for 40 preschool children. There are three toilets and three sinks for the children, and a separate private restroom for the staff. Individual measurements are recorded on the Capacity Worksheet (LIC 9024). Children who become ill during the day will be isolated in the staff/kitchen area and will use the staff restroom, if necessary.

OUTDOOR ACTIVITY SPACE:
There is one outdoor area on the property. The outdoor play area is fenced with a wrought iron fence that is at least four feet tall. AS observed a sufficient amount of equipment and toys. There are no bodies of water on the premises. There is a shade sail that extends from the fence to the building. Applicant stated that staff will bring children's water bottles outside.

The outdoor play area contains a total of 1534.735 square feet, which does not accommodate the request for 40 preschool children. The outdoor space measures for a maximum of 20 children. A waiver request to utilize a rotating schedule where no more than 20 children will use the outdoor space at one time will be submitted. Individual measurements are recorded on the Capacity Worksheet (LIC 9024).

Incidental Medical Services and a Plan of Operation is located in the facility file. Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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)/(800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

Report continues on 809-C.

SUPERVISORS NAME: Roxana Saravia
LICENSING EVALUATOR NAME: Seychelle De Luca
LICENSING EVALUATOR SIGNATURE:	DATE: 04/06/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/06/2021

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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: BUILDING KIDZ OF CITRUS HEIGHTS	FACILITY NUMBER: 343623893
	VISIT DATE: 04/06/2021

NARRATIVE

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AS discussed the following: 100% supervision is required at all times, including in the bathroom; personal rights; inspection authority; reporting requirements; staff to children ratios and capacity; staff qualifications; and maintaining buildings and grounds. AS discussed with Applicant any changes that may occur regarding the director or an employee acting in the director's absence must be reported to department within 10 working days.

Applicant was encouraged to the visit the Department's website at WWW.CDSS.CA.GOV for information regarding child care updates, forms, regulations and legislation pertaining to child care centers.

This facility evaluation report was reviewed and discussed with Applicant. AS emailed a copy of the 809 to Applicant. Applicant understands she must reply that she received, read, and understands today's report.

CONDITIONS REQUIRING CORRECTION PRIOR TO ISSUING A LICENSE:

1. Applicant will submit a waiver request for the outdoor space.
2. A final review of the file by Licensing Program Manager (LPM) Keven Peters.

SUPERVISORS NAME: Roxana Saravia
LICENSING EVALUATOR NAME: Seychelle De Luca
LICENSING EVALUATOR SIGNATURE:	DATE: 04/06/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/06/2021

LIC809 (FAS) - (06/04)

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