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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343622630
Report Date: 11/17/2022
Date Signed: 11/17/2022 04:12:39 PM

Document Has Been Signed on 11/17/2022 04:12 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:
343622630
ADMINISTRATOR:WILLIAMS, COURTNEYFACILITY TYPE:
850
ADDRESS:7312 ANTELOPE ROADTELEPHONE:
(916) 689-8687
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95621
CAPACITY: 59TOTAL ENROLLED CHILDREN: 59CENSUS: 11DATE:
11/17/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Janet WongTIME COMPLETED:
04:45 PM
NARRATIVE
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On November 17, 2022, Licensing Program Analysts (LPAs) Lea Habtom and Amanda Blesi met with designated representative, Janet Wong, for the purpose of an unannounced required 1 year inspection. Operating hours of the facility are from 6:30 a.m.-6:30 p.m., Monday thru Friday. Director guided LPA on a tour of the facility, at which time a census of 11 preschool children supervised by 3 staff was observed.

All individuals subject to criminal background review have obtained criminal record clearance. Director 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.

A health and safety inspection was conducted in the classrooms, restrooms, food service areas, and outdoor play areas. LPA observed the following documents are posted: License, Emergency Disaster Plan, Personal Rights, Parents' Rights Poster, menus, and daily schedule. Cleaning disinfectants and hazardous items are appropriately stored and inaccessible to children. Medications are stored, inaccessible to children. Expired medication was observed and authorization to administer medication was not included. Designated representative stated there are no poisons on the premises. Furniture and equipment are in good condition. The one staff bathroom was out of order. Bins for solid waste have tight fitting lids. The floors appeared clean throughout the facility. The facility provides breakfast, lunch, and afternoon snack. The food preparation space is free of litter and all food was protected against contamination. Milk with an expiration date was observed in the fridge of October 30, 2022. There was no back up milk in the fridge. Drinking water was readily available to children both indoors and outdoors via drinking fountains and labeled bottles. Facility uses an online application for sign in and sign out. LPA observed full legal signatures of authorized representatives. There are no firearms or bodies of water on the premises. LPA observed a functional carbon monoxide detector. Playground equipment and surfaces are free of loose or sharp

Report continues on 809-C.

SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Lea Habtom
LICENSING EVALUATOR SIGNATURE: DATE: 11/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/17/2022
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: 343622630
VISIT DATE: 11/17/2022
NARRATIVE
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parts. LPA observed wood chip cushioning beneath the play structure. Outdoor shade is provided by trees.

Staff files were reviewed. At least one staff member present today has current Pediatric CPR and First Aid certification. Staff members immunization's were missing and documentation of the educational background, training, and/or experience and AB 1207 Mandated Reporter training certificates.

Children's records were reviewed. Each child's file contained an emergency card, consent for emergency medical treatment and notifications of children’s and parent’s rights, health history, physician's report and immunization records. LPA observed signed form LIC224 Acknowledgement of receipt of licensing reports.

This facility provides Incidental Medical Services – IMS. A plan of operation is on file at the facility. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s personnel and administrative records. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.

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 verified the annual fees are current. A staff interview was conducted with the designated representative Janet Wong.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to [email protected]. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

In the areas that were evaluated, deficiencies were cited during today’s inspection cited on 809-D. Exit interview conducted and report was reviewed with Janet Wong. A notice of site visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Lea Habtom
LICENSING EVALUATOR SIGNATURE:

DATE: 11/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2022
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Document Has Been Signed on 11/17/2022 04:12 PM - It Cannot Be Edited


Created By: Lea Habtom On 11/17/2022 at 03:33 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: 343622630

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/17/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
101226(e)(2)
Health-Related Services
(2) All prescription and nonprescription medications shall be maintained with the child's name and shall be dated.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the center did not comply with the section cited above in that medications were expired, did not have children names, were not stored in the original box and did not have instructions from parent to adminster the medication which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 11/21/2022
Plan of Correction
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Valeyncia checked the medication expiratation dates and discarded those that are expired. LPA L. Habtom also made facility staff aware of authorization form neeeded from parents to adminster medication, LIC 9221. LPA L. Habtom will make a return visit.
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: 11/17/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/17/2022


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Document Has Been Signed on 11/17/2022 04:12 PM - It Cannot Be Edited


Created By: Lea Habtom On 11/17/2022 at 03:33 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: 343622630

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/17/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101238(a)
Buildings and Grounds
(a) The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the facility staff did not comply with the section cited above in that the only staff restroom was out of order which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/19/2022
Plan of Correction
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Facility representative agreed to fix toilet and notify LPA once toilet is fixed. LPA L. Habtom will make a return visit.
Type B
Section Cited
HSC
1596.7995(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

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 two staff members did not have proof of immunization records pertussis & measles which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/19/2022
Plan of Correction
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Assigned representative agreed to collect the immunizations and send to LPA L. Habtom via email by POC due date.
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: 11/17/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/17/2022


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Document Has Been Signed on 11/17/2022 04:12 PM - It Cannot Be Edited


Created By: Lea Habtom On 11/17/2022 at 03:33 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: 343622630

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/17/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
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 there is no designated director on file which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/19/2022
Plan of Correction
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Designated representative agreed to provide director packet to LPA L. Habtom by POC due date via email.
Type B
Section Cited
CCR
101227(a)(19)
Food Service
(19) All food shall be protected against contamination. Contaminated food shall be discarded immediately.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in that one the only carton of milk in the fridge has an expiration date of October 30, 2022 which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/22/2022
Plan of Correction
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LPA L. Habtom verified that the milk was dumped before leaving the facility and made facility staff aware to check expiratation dates on the food.
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: 11/17/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/17/2022


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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: 343622630
VISIT DATE: 11/17/2022
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Title 22 Deficiency has been cited on the attached LIC 809-D. LPA Lea Habtom informed Janet Wong that this report dated November 17, 2022 document(s) oneType A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care. Also, LPA Lea Habtom informed Janet Wong to provide a copy of this licensing report dated November 17, 2022 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification. Appeal Rights given.
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Lea Habtom
LICENSING EVALUATOR SIGNATURE:

DATE: 11/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2022
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