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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343623950
Report Date: 05/20/2022
Date Signed: 05/20/2022 03:42:03 PM

Document Has Been Signed on 05/20/2022 03:42 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: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: 12TOTAL ENROLLED CHILDREN: 12CENSUS: 9DATE:
05/20/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Valeyncia JonesTIME COMPLETED:
04:15 PM
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*All times are approximate* On May 20, 2022 around 9:30 am Licensing Program Analysts (LPAs) Lea Habtom and Tanya Washington arrived around 9:30 AM for an annual/required inspection and met with the lead staff Valeyncia Nims. The facility file was reviewed prior to this inspection. A review of the personnel report indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. The facility’s operating hours are 6:30 am - 6:00 pm, Mon-Fri. The facility was toured around 9:45 am inside and outside and the floor and yard plan submitted by the licensee were verified. There are no pools or similar bodies of water. The Director stated no firearms or weapons are stored on site and none were observed. The items which could pose a danger to children are inaccessible to children. Poisons are locked within the janitorial office within the school and other cleaning solutions are kept away from children. Furniture and equipment are in good condition, free of hazards, and age appropriate. The outdoor activity play area is shared by different age groups and licensee was reminded to provide a request for a waiver for the shared space. No waiver is on file for the infant play yard. Toilets and sinks are in sanitary condition and operating properly. The facility floors were clean and safe. The kitchen/food preparation area is clean, and free of litter or rodents. Food is properly stored and free of contamination. Trash cans have tight fitting lids. Drinking water is available indoor via children's individual water bottles. Outdoor water is made availabe by a water jug and cups that are brought outside. The facility was free of flies, insects and rodents. The facility has a working carbon monoxide detector. During today's inspection, staffing ratios were being met and there were 9 infants being supervised by 2 teachers & 1 aide. Infants are not left without visual supervision at any time. The facility was operating within the licensed capacity. At least one staff member present during the visit possessed current CPR and First Aid certifications. The sign in/out sheet was reviewed via the procare electronic application, and representatives are using electronic signatures and recording the time. Staff are provided on-the-job training, including sanitation and universal precautions. Infants with symptoms of illness are not accepted, and children who become ill during the day are isolated in kitchen area or up front where they can be separated from other children. A weekly menu was posted at the parents board.

Report continued on 809-C
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Lea Habtom
LICENSING EVALUATOR SIGNATURE: DATE: 05/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/20/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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: TOTS OF LOVE - CITRUS HEIGHTS
FACILITY NUMBER: 343623950
VISIT DATE: 05/20/2022
NARRATIVE
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The facility has a crib or mat/cot for each napping infant. Cribs are free of loose objects. Infants are visually supervised at all times while sleeping however staff could not provide physical documentation of the 15 minute visual checks. A few infant bottles and sippy cups were observed with no date and name labels. sleeping infants every 15 minutes. Infants under 12 months are placed on their backs for sleep, and no infants are swaddled. Children records were reviewed around 10:00 am and contained emergency identification forms, medical assessments, and a few needs and Services Plans were incomplete or missing. Infants up to 12 months have an Infant Sleeping Plan on file. A few staff records were reviewed around 10:00 AM, and contained proof of qualifications. All licensing reports are public information and must be made available upon request for at least three years.

Review 809-D for the following type B citations. Appeal rights were provided and the notice of site visit was provided.
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Lea Habtom
LICENSING EVALUATOR SIGNATURE:

DATE: 05/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2022
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Document Has Been Signed on 05/20/2022 03:42 PM - It Cannot Be Edited


Created By: Lea Habtom On 05/20/2022 at 01:39 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: TOTS OF LOVE - CITRUS HEIGHTS
FACILITY NUMBER: 343623950

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/20/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101174(d)(2)
Disaster and Mass Casualty Plan
(d) Disaster drills shall be conducted at least every six months. (2) The drills shall be documented. This documentation shall be kept in the child care center for at least one year.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, that the head teacher did not provide written proof of the last fire drill conducted which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/30/2022
Plan of Correction
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Head teacher, Mrs. Dawnica, agreed to submit written documentation of the next fire drill conducted.
Type B
Section Cited
CCR
101215.1(b)
Child Care Center Director Qualifications and Duties
(b) All child care centers shall have a director.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in that multiple sites managed by the licensee share the same director which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/30/2022
Plan of Correction
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Licensee, Courtney Williams, was made aware to submit paperwork to assign a new director to LPA L. Habtom via email and confirm the change has been made.
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:Keven Peters
LICENSING EVALUATOR NAME:Lea Habtom
LICENSING EVALUATOR SIGNATURE:
DATE: 05/20/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/20/2022


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Document Has Been Signed on 05/20/2022 03:42 PM - It Cannot Be Edited


Created By: Lea Habtom On 05/20/2022 at 01:39 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: TOTS OF LOVE - CITRUS HEIGHTS
FACILITY NUMBER: 343623950

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/20/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101419.2(a)
Infant Needs and Services Plan
(a) Prior to the infant's first day at the center, the infant care center director or assistant director shall complete a needs and services plan for the infant.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in that a majority of infant files were either missing the needs and services forms or the forms were outdated. This poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/30/2022
Plan of Correction
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Head teacher, Mrs. Nims agreed to review infant files and have parents complete needs & services plan, file in each child's infant files and email to LPA L. Habtom.
Type B
Section Cited
CCR
101429(a)(2)(C)(3)
Responsibility for Providing Care and Supervision for Infants
(C) Documentation shall be maintained in the infant’s file and be available to the Department for review. Documentation shall include the following: (3) Time of each 15-minute check

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in staff could not provide 15 minute checks used on the procare app for infants that nap. This poseses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/30/2022
Plan of Correction
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Head teacher, Mrs. Nims, agreed to review with staff to document sleep checks every 15 minutes and provide a screen shot to LPA L. Habtom.
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:Keven Peters
LICENSING EVALUATOR NAME:Lea Habtom
LICENSING EVALUATOR SIGNATURE:
DATE: 05/20/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/20/2022


LIC809 (FAS) - (06/04)
Page: 4 of 5
Document Has Been Signed on 05/20/2022 03:42 PM - It Cannot Be Edited


Created By: Lea Habtom On 05/20/2022 at 01:39 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: TOTS OF LOVE - CITRUS HEIGHTS
FACILITY NUMBER: 343623950

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/20/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101427(j)
Infant Care Food Service
(j) Bottles, dishes and containers of food brought by the infant's authorized representative shall be labeled with the infant's name and the current date.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, staff failed to label a majority of the bottles with name and date. LPAs observed some with name. This poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/30/2022
Plan of Correction
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LPA L. Habtom will return for proof of correction to inspect bottles.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Keven Peters
LICENSING EVALUATOR NAME:Lea Habtom
LICENSING EVALUATOR SIGNATURE:
DATE: 05/20/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/20/2022


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