343624762-3-28-2023-03-CC-MLOR-CQCPEX-20230328111553

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343624762
Report Date: 03/28/2023
Date Signed: 03/28/2023 11:16:05 AM

Document Has Been Signed on 03/28/2023 11:16 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
RIVER CITY (SACTO)CC, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME:	SINGLE MOM STRONG-EMPOWERME PS & CC		FACILITY NUMBER:	343624762
ADMINISTRATOR:	KINZ, KIMBERLY		FACILITY TYPE:	830
ADDRESS:	7525 AUBURN BLVD, SUITE 5		TELEPHONE:	(916) 735-5350
CITY:	CITRUS HEIGHTS	STATE: CA	ZIP CODE:	95610
CAPACITY: 6	TOTAL ENROLLED CHILDREN: 6	CENSUS: 0	DATE:	03/28/2023
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Tara Taylor		TIME COMPLETED:	11:30 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) Mai Lor and Licensing Program Analyst (LPA) Karyn Guerra met with Applicant Tara Taylor for the purpose of an announced pre-licensing inspection. Applicant is requesting an infant license serve 18 infant children from birth to 24 months in Suite 7. During today's inspection, the applicant is requesting to remove the toddler option classroom, which was originally licensed for 12 toddler option children under the preschool license. Applicant is requesting to add this classroom to the infant license. The program will operate Monday through Friday from 7:30 AM to 5:30 PM. The fire clearance was granted on 03/21/2023 for six infants. AS reviewed with applicant the LIC 311A, Records To Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted. Applicant acknowledges that the following documents must be posted at all times: License, Emergency Disaster Plan, Personal Rights, Parents' Rights Poster, Effects of Lead Exposure, car seat poster, menus, and daily schedule. Applicant stated the Needs and Services plans will be kept in the classrooms. Parents will provide formula, breast milk, and baby food/lunch for their children. Facility will provide morning and afternoon snacks for infant on who are on solid. INDOOR ACTIVITY SPACE: There are two infant classrooms (Infant 0-12 months and Toddler Classroom age 18-36 months). The classrooms is equipped with sufficient infant size furnishing, cubbies and a variety of age-appropriate toys that appear to be in good repair. AS observed three cribs in the napping room. Applicant acknowledges there will be a maximum of three infants under 12 months old, due to available cribs. AS and LPA did not observe a separate napping area from the activity space. Applicant was advised that the infant napping area must be physically separate from the indoor activity space. (Report continued on subsequent LIC 809)

SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Mai Lor
LICENSING EVALUATOR SIGNATURE:	DATE: 03/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2023

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
RIVER CITY (SACTO)CC, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: SINGLE MOM STRONG-EMPOWERME PS & CC	FACILITY NUMBER: 343624762
	VISIT DATE: 03/28/2023

NARRATIVE

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AS observed the classroom to be clean, safe, sanitary and in good repair. AS observed containers used for storage of solid wastes, including moveable bins, to have a tight-fitting cover that is kept on and in good repair.

There is a first aid kit in the toddler option classroom. Medication will be stored in the office and inaccessible to children in care. AS and LPA observed cleaning disinfectants appropriately stored and inaccessible to children. Applicant stated there are no firearms or weapon on the premises. Applicant stated indoor and outdoor drinking water will be provided via tap water. AS and LPA observed a carbon monoxide detector in the facility. Applicant stated they will be using paper sign in and sign out system.

AS and LPA measured the new infant classroom which contains a total of 217.84 square feet. The existing toddler option classroom was previously measured on 10/13/22 with a total 532.29 square feet. The total classroom space contains a total of 750.13 square feet, which will accommodate Applicant's requested capacity for 18 infant children. There are two sinks available in the classrooms. Applicant stated infants will not be potty trained in the infant program; however, there are two toddler toilets in the toddler classroom that can be utilized. AS and LPA observed a counter changing pad that is at least one inch think but did not observe a changing table with raised sides that are at least three inches tall. There is a sink within arm’s reach of the changing area. Children who become ill during the day will be isolated in the office area and will use the staff restroom, if necessary.

OUTDOOR ACTIVITY SPACE:
There is an enclosed outdoor activity space for preschool children. Applicant stated the infant children will be utilizing the preschool outdoor activity space and will submit a waiver to share the preschool playground on a rotating schedule. The applicant was reminded to use age-appropriate equipment and toys. The outdoor play area is surrounded by a fence that is at least four feet tall. The outdoor space has adequate shade.

The outdoor space was previously measured during the pre-licensing inspection on 06/14/2019 and has not changed. The previous measurement was 1,501 square feet.

(Report continued on subsequent LIC 809)

SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Mai Lor
LICENSING EVALUATOR SIGNATURE:	DATE: 03/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2023

LIC809 (FAS) - (06/04)

Page: 2 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVER CITY (SACTO)CC, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: SINGLE MOM STRONG-EMPOWERME PS & CC	FACILITY NUMBER: 343624762
	VISIT DATE: 03/28/2023

NARRATIVE

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AS discussed the following: 100% supervision is required at all times; 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.

This facility plans to provide Incidental Medical Services – IMS. For IMS information, see PIN 22-02-CCP. A 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.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage athttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Applicant was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Licensee was encouraged to visit the Department website at WWW.CCLD.CA.GOV for child care updates, current forms, legislation and regulation information. A copy of this report will remain on file for a period of three years for public review upon request.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.

(Report continued on subsequent LIC 809)

SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Mai Lor
LICENSING EVALUATOR SIGNATURE:	DATE: 03/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2023

LIC809 (FAS) - (06/04)

Page: 3 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVER CITY (SACTO)CC, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: SINGLE MOM STRONG-EMPOWERME PS & CC	FACILITY NUMBER: 343624762
	VISIT DATE: 03/28/2023

NARRATIVE

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To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

The following items are required before a license will be issued:

1. Shared outdoor space waiver with a rotating schedule

2. Separation wall between the infant napping area and the indoor activity space.

3. Infant changing table

4. Updated fire clearance

Exit interview conducted and report was reviewed with the Applicant, Tara Taylor.

SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Mai Lor
LICENSING EVALUATOR SIGNATURE:	DATE: 03/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2023

LIC809 (FAS) - (06/04)

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