BUILDING KIDZ OF FOLSOM

Type A citation - immediate risk to health, safety, or personal rights

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25Licensing Program Analyst (LPA) Erwina Pascual-Golamco, met with Facility Representative (FR) Victoria Varman, for a case management inspection regarding an incident on 09/16/25 in their Preschool Component. Purpose of the visit was explained. Licensee (L) Puneet Nathani self reported and submitted a written Unusual Incident Report LIC624, that on 09/16/25, at approximately 3:30PM, a staff began to feel unwell and left another staff alone with 16 preschool children in the outdoor play yard. According to FR, the staff that was left alone with the preschool group brought the children back to the classroom and was out of ratio for approximately 20 minutes, until Licensee (L), Puneet Nathani arrived at the facility to help with supervision. According to FR, Licensee investigated, interviewed staff and witnesses and took necessary actions. Based on interview and record review with FR, Type A Title 22 Deficiency has been issued on the attached LIC 809-D page. LPA informed FR, Victoria Varman, that this report dated 09/23/25 documents one Type A citation which shall be posted for 30 consecutive days as there is immediate risk to the health, safety, or personal rights of children in care. LPA informed FR to provide a copy of this licensing report dated 09/23/25 that documents any Type A citation 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. A Notice Of Site visit was given to FR, and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. FR has been provided with appeal rights. Exit interview was conducted, report was reviewed with the FR, Victoria Varman. NAME OF LICENSING PROGRAM MANAGER: Jeevun Birk-Miller NAME OF LICENSING PROGRAM ANALYST: Erwina Pascual-Golamco LICENSING PROGRAM ANALYST SIGNATURE: DATE: 09/23/2025 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/23/2025 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 3 FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form. DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies: Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care. Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care. PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency. CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptl

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25Licensing Program Analyst (LPA) Erwina Pascual-Golamco, met with Facility Representative (FR) Victoria Varman, for a case management inspection regarding an incident on 09/16/25 in their Preschool Component. Purpose of the visit was explained. Licensee (L) Puneet Nathani self reported and submitted a written Unusual Incident Report LIC624, that on 09/16/25, at approximately 3:30PM, a staff began to feel unwell and left another staff alone with 16 preschool children in the outdoor play yard. According to FR, the staff that was left alone with the preschool group brought the children back to the classroom and was out of ratio for approximately 20 minutes, until Licensee (L), Puneet Nathani arrived at the facility to help with supervision. According to FR, Licensee investigated, interviewed staff and witnesses and took necessary actions. Based on interview and record review with FR, Type A Title 22 Deficiency has been issued on the attached LIC 809-D page. LPA informed FR, Victoria Varman, that this report dated 09/23/25 documents one Type A citation which shall be posted for 30 consecutive days as there is immediate risk to the health, safety, or personal rights of children in care. LPA informed FR to provide a copy of this licensing report dated 09/23/25 that documents any Type A citation 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. A Notice Of Site visit was given to FR, and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. FR has been provided with appeal rights. Exit interview was conducted, report was reviewed with the FR, Victoria Varman. NAME OF LICENSING PROGRAM MANAGER: Jeevun Birk-Miller NAME OF LICENSING PROGRAM ANALYST: Erwina Pascual-Golamco LICENSING PROGRAM ANALYST SIGNATURE: DATE: 09/23/2025 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/23/2025 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 3 FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form. DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies: Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care. Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care. PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency. CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptl