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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 394500377
Report Date: 04/23/2024
Date Signed: 04/23/2024 04:02:21 PM

Document Has Been Signed on 04/23/2024 04:02 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 S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:KIDS PLACE 2 EXPLORE & LEARN LLCFACILITY NUMBER:
394500377
ADMINISTRATOR/
DIRECTOR:		CARINA DIAZ DE BARAJASFACILITY TYPE:
850
ADDRESS:9371 N. LOWER SACRAMENTO ROADTELEPHONE:
(209) 478-6161
CITY:STOCKTONSTATE: CAZIP CODE:
95210
CAPACITY: 90TOTAL ENROLLED CHILDREN: 60CENSUS: 33DATE:
04/23/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Alvarado, JecelynTIME VISIT/
INSPECTION COMPLETED:
04:30 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
On April 23rd, 2024, at 10:00 AM, Licensing Program Analysts (LPAs), Elizabeth Santiago and David Nguyen conducted an unannounced field visit to the facility for the purpose of a case management inspection to follow up on an incident reported LPA Santiago via email on April 22nd, 2024. LPAs arrived at the facility and were met by Director, Jocelyn Alvarado. LPAs disclosed the purpose of the inspection and were granted entrance into the facility. Thirty-three (33) preschool aged children were present during today’s inspection. LPA determined, through accessing Guardian, that all required adults were background cleared and associated to the license.

LPA toured the facility, observed the care and supervision of children, reviewed records and conducted onsite interviews with Director and teachers. Interviews revealed that on Monday, April 15th, 2024, a child (C1) was left outside during transition, but it was determined that other staff member was present during transitions, and child was not left without supervision. However, on Wednesday, April 17th, 2024, C1 was left on playground again by a staff member (S1). While another staff member (S2) was attending to C1, S2 was notified by other children that a second child (C2) was in the bathroom unattended. S2 determined that C1 and C2 were not from her classroom and belonged to another classroom.

It was determined that C2 was left unattended in the bathroom by S1 which is a lack of supervision, which poses an immediate health, safety, or personal rights risk to persons in care. As a result of the lack of supervision, a Type A violation was cited on a subsequent 809-D page.

Report continues on LIC809-C...(Page 2)

SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: David Nguyen
LICENSING EVALUATOR SIGNATURE: DATE: 04/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/23/2024
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 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: KIDS PLACE 2 EXPLORE & LEARN LLC
FACILITY NUMBER: 394500377
VISIT DATE: 04/23/2024
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
(Page 2)
It also revealed that Director did not notify the Unusual Incident Report (UIR) to the Community Care Licensing Division (CCLD) within 24 hours, which poses a potential risk to children in care.

One (1) Type A and one (1) Type B violations were assessed on a subsequent 809-D page. Director shall post LIC 809-D with Type A deficiency for 30 days and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. LIC9224 must be signed by parents/guardians and kept with the children's forms as a receipt whenever any Type A documents are provided by the Licensees.

An exit interview was conducted, and the report was reviewed with Director. LPA provided Director with Licensee Appeal Rights. A Notice of Site visit was posted by LPA and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: David Nguyen
LICENSING EVALUATOR SIGNATURE:

DATE: 04/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/23/2024
LIC809 (FAS) - (06/04)
Page: 2 of 4
Document Has Been Signed on 04/23/2024 04:02 PM - It Cannot Be Edited


Created By: David Nguyen On 04/23/2024 at 03:37 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: KIDS PLACE 2 EXPLORE & LEARN LLC
FACILITY NUMBER: 394500377

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/23/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/23/2024
Section Cited
CCR
101229(a)(1)

1
2
3
4
5
6
7
(a) The licensee shall provide care and supervision...to meet children's needs.
(1) No child(ren) shall be left without the supervision of a teacher at any time, …Supervision shall include visual observation.


1
2
3
4
5
6
7
Staff Meeting will be held to focus on Supervision. Director will email LPA the sign-in sheet from this meeting.
8
9
10
11
12
13
14
This requirement was not met as evidenced by through observation it was determine that C2 was left in the bathroom unattended.
8
9
10
11
12
13
14
Director will create a written statement for staff to sign that describes supervision policy and procedures will be expected of staff for the future. Director emailed the signed statements to LPA.

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
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:Chayntel Hunter
LICENSING EVALUATOR NAME:David Nguyen
LICENSING EVALUATOR SIGNATURE:
DATE: 04/23/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/23/2024


LIC809 (FAS) - (06/04)
Page: 3 of 4
Document Has Been Signed on 04/23/2024 04:02 PM - It Cannot Be Edited


Created By: David Nguyen On 04/23/2024 at 03:44 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: KIDS PLACE 2 EXPLORE & LEARN LLC
FACILITY NUMBER: 394500377

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/23/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/23/2024
Section Cited
CCR
101212(d)(1)(C)

1
2
3
4
5
6
7
(d) Upon the occurrence…a report shall be made to the Department within the Department's next working day…
(C) Any unusual incident… that threatens the physical or emotional health or safety of any child.

This requirement was not met as evidenced by:
1
2
3
4
5
6
7
Director, Jocelyn Alvarado will create a written statement and acknowledges that she does understand the reporting requirements when any unusual incident occurs at the child care center during the hours and days of operation.
8
9
10
11
12
13
14
Based on record review and interview, Director did not notify the UIR to CCLD within 24 hours, which poses a potential risk to children in care.
8
9
10
11
12
13
14
Director will also submit a written UIR within by end of date tomorrow 4/24/2024 to meet 7 day requirement. Director, Jocelyn Alvarado will email the signed statement to LPA Elizabeth Santiago.

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
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:Chayntel Hunter
LICENSING EVALUATOR NAME:David Nguyen
LICENSING EVALUATOR SIGNATURE:
DATE: 04/23/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/23/2024


LIC809 (FAS) - (06/04)
Page: 4 of 4