<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343623950
Report Date: 06/18/2021
Date Signed: 06/21/2021 10:20:12 AM

Document Has Been Signed on 06/21/2021 10:20 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:TOTS OF LOVE - CITRUS HEIGHTSFACILITY NUMBER:
343623950
ADMINISTRATOR:COURTNEY WILLIAMSFACILITY TYPE:
830
ADDRESS:7312 ANTELOPE RDTELEPHONE:
(916) 560-9699
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95621
CAPACITY: 20TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
06/18/2021
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
08:40 AM
MET WITH:Courtney WilliamsTIME COMPLETED:
12:15 PM
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
Licensing Program Analyst (LPA) Christopher Bello and Licensing Program Manager (LPM) Keven Peters conducted a site inspection for the purpose of a prelicensing evaluation. LPA met with applicant Courtney Williams. The facility is requesting an infant license with a capacity of 20 infants. Upon further inspection applicant requested to care for 12 infants. LPAs observed that the facility had the required documents posted on the parent board in the main entrance of the facility: Parents Rights, Personal Rights, Car Seat Law, Emergency Disaster Plan, Earthquake Checklist, Electronic sign in/out waiver and facility Menu. The facility will operate Monday-Friday from 6:30am-6:00pm. LPA reviewed all required records with the applicant that the facility must maintain for all the children, staff and volunteers LPAs advised applicants that the Infants Needs and Service Plan must be updated quarterly. LPA advised applicants that anyone working in the facility must obtain a criminal record clearance through Community Care Licensing. LPA also discussed staffing qualifications and ratio/capacity regulations for an infant program with applicants. LPA also discussed the infant napping and supervision requirements as wells as Safe Sleep practices and SIDS.
LPA discussed Departments inspection authority regulations with the applicants and informed them that if any changes occur regarding the Designee/Director or an employee acting in their absence must be reported to Department within 10 working days. LPA also discussed Unusual Incident Reports (UIRs) and reporting requirements. LPAs advised applicants that if any unusual incidents occur they must contact the Department within 24 hours and an UIR must be submitted with 7 day, describing the specifics to the

INDOOR ACTIVITY SPACE:
Butterflies Room = 379.78 square feet
Caterpillar Room = 282.84 square feet
The total square feet will support the requested 12 children.

Report continues LIC809C
**THIS IS AN AMENDED REPORT**
SUPERVISORS NAME: Roxana Saravia
LICENSING EVALUATOR NAME: Christopher Bello
LICENSING EVALUATOR SIGNATURE: DATE: 06/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/18/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
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: TOTS OF LOVE - CITRUS HEIGHTS
FACILITY NUMBER: 343623950
VISIT DATE: 06/18/2021
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
26
27
28
29
30
31
32
The classrooms are equipped with infant size furnishing and age appropriate toys that appear to be in good repair. LPA observed there were sinks within arm’s reach of the changing table. The changing tables have raised edges that exceed the required 3 inches. There is a separate staff bathroom. There are cubbies for storing infant's personal belongings in each classroom and the facility has four cribs in the infant nap room, applicant stated the facility will wash the sheets daily.
Snacks will be prepared in the kitchen, food preparation area, equipment, dishes are sanitary and in good repair. The facility will provide AM/PM snack and the parents will provide any food for infants. Bottles will be brought from home, labeled, dated and returned daily. The facility will use a bottle warmer to warm the bottles.

The applicant will use the office to isolate sick children and the children will be accompanied by a qualified staff. LPA advised applicants on medication requirements and they are aware that all medications must be centrally stored. The facility has a locked box and fridge in the Director's office for medications. 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.

OUTDOOR ACTIVITY SPACE:
The outdoor activity space was measured to be 6232.965 square feet.

The following to be submitted prior to approval;
1) Shared Playground waiver
2) Applicant will provide pictures with the wall fixtures setup and cribs
3) Fire Clearance

Once the above items have been completed, LPA and LPM Keven Peters will review the application. Upon LPM's approval LPA will recommend a provisional license for 12 infants ages 0 – 2 years old with infants ages 0 - 1 years old limited to the amount of cribs in place.
**THIS IS AN AMENDED REPORT**
SUPERVISORS NAME: Roxana Saravia
LICENSING EVALUATOR NAME: Christopher Bello
LICENSING EVALUATOR SIGNATURE:

DATE: 06/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2021
LIC809 (FAS) - (06/04)
Page: 2 of 2