ADVENTURE CLUB - KASEBERG

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

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 Manager (LPM) Mai Lor and Licensing Program Analyst (LPA) Jeremey McClain met with Recreation Superintendent Melanie Nett and Site Supervisor Sarah Beeson for the purpose of an Informal Office Meeting. LPM Lor defined the difference between a Non-Compliance and an Informal Meeting. The purpose of today’s Informal Office Meeting was to discuss the Unusual Incidents which occurred on 10/27/2025 and was reported to the licensing office within the required time frame. On 10/25/2025 at approximately 9:35 am, Staff 1 observed Child 1 alone in the classroom when they arrived at the facility. It was stated that the child was forgotten during dismissal by Staff 2 and Staff 3 when other children in attendance were dismissed to school. It was stated that Child 1 fell asleep when they arrived around 6:45 am and reportedly woke up around 8am. Child 1 was not observed to have had any injuries. Staff 2 and 3 no longer work at the facility. The following citations and regulation was discussed: 101229 (a)(1) Care and Supervision, Zero Tolerance, cited on 01/23/2025 and 10/30/2025. Facility representatives stated procedures are in place to ensure no child is left without supervision. They stated Staff 2 and 3 did not follow the procedures. Procedures include using a name to face for all children and doing an extra check at the site at dismissal to ensure every child is accounted for. Representatives stated all staff have been retrained on supervision procedures. (1/2) NAME OF LICENSING PROGRAM MANAGER: Mai Lor NAME OF LICENSING PROGRAM ANALYST: Jeremey McClain LICENSING PROGRAM ANALYST SIGNATURE: DATE: 11/14/2025 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/14/2025 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 promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given. CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the l

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 Manager (LPM) Mai Lor and Licensing Program Analyst (LPA) Jeremey McClain met with Recreation Superintendent Melanie Nett and Site Supervisor Sarah Beeson for the purpose of an Informal Office Meeting. LPM Lor defined the difference between a Non-Compliance and an Informal Meeting. The purpose of today’s Informal Office Meeting was to discuss the Unusual Incidents which occurred on 10/27/2025 and was reported to the licensing office within the required time frame. On 10/25/2025 at approximately 9:35 am, Staff 1 observed Child 1 alone in the classroom when they arrived at the facility. It was stated that the child was forgotten during dismissal by Staff 2 and Staff 3 when other children in attendance were dismissed to school. It was stated that Child 1 fell asleep when they arrived around 6:45 am and reportedly woke up around 8am. Child 1 was not observed to have had any injuries. Staff 2 and 3 no longer work at the facility. The following citations and regulation was discussed: 101229 (a)(1) Care and Supervision, Zero Tolerance, cited on 01/23/2025 and 10/30/2025. Facility representatives stated procedures are in place to ensure no child is left without supervision. They stated Staff 2 and 3 did not follow the procedures. Procedures include using a name to face for all children and doing an extra check at the site at dismissal to ensure every child is accounted for. Representatives stated all staff have been retrained on supervision procedures. (1/2) NAME OF LICENSING PROGRAM MANAGER: Mai Lor NAME OF LICENSING PROGRAM ANALYST: Jeremey McClain LICENSING PROGRAM ANALYST SIGNATURE: DATE: 11/14/2025 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/14/2025 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 promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given. CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the l

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 Manager (LPM) Mai Lor and Licensing Program Analyst (LPA) Jeremey McClain met with Recreation Superintendent Melanie Nett and Site Supervisor Sarah Beeson for the purpose of an Informal Office Meeting. LPM Lor defined the difference between a Non-Compliance and an Informal Meeting. The purpose of today’s Informal Office Meeting was to discuss the Unusual Incidents which occurred on 10/27/2025 and was reported to the licensing office within the required time frame. On 10/25/2025 at approximately 9:35 am, Staff 1 observed Child 1 alone in the classroom when they arrived at the facility. It was stated that the child was forgotten during dismissal by Staff 2 and Staff 3 when other children in attendance were dismissed to school. It was stated that Child 1 fell asleep when they arrived around 6:45 am and reportedly woke up around 8am. Child 1 was not observed to have had any injuries. Staff 2 and 3 no longer work at the facility. The following citations and regulation was discussed: 101229 (a)(1) Care and Supervision, Zero Tolerance, cited on 01/23/2025 and 10/30/2025. Facility representatives stated procedures are in place to ensure no child is left without supervision. They stated Staff 2 and 3 did not follow the procedures. Procedures include using a name to face for all children and doing an extra check at the site at dismissal to ensure every child is accounted for. Representatives stated all staff have been retrained on supervision procedures. (1/2) NAME OF LICENSING PROGRAM MANAGER: Mai Lor NAME OF LICENSING PROGRAM ANALYST: Jeremey McClain LICENSING PROGRAM ANALYST SIGNATURE: DATE: 11/14/2025 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/14/2025 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 promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given. CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the l

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 Manager (LPM) Mai Lor and Licensing Program Analyst (LPA) Jeremey McClain met with Recreation Superintendent Melanie Nett and Site Supervisor Sarah Beeson for the purpose of an Informal Office Meeting. LPM Lor defined the difference between a Non-Compliance and an Informal Meeting. The purpose of today’s Informal Office Meeting was to discuss the Unusual Incidents which occurred on 10/27/2025 and was reported to the licensing office within the required time frame. On 10/25/2025 at approximately 9:35 am, Staff 1 observed Child 1 alone in the classroom when they arrived at the facility. It was stated that the child was forgotten during dismissal by Staff 2 and Staff 3 when other children in attendance were dismissed to school. It was stated that Child 1 fell asleep when they arrived around 6:45 am and reportedly woke up around 8am. Child 1 was not observed to have had any injuries. Staff 2 and 3 no longer work at the facility. The following citations and regulation was discussed: 101229 (a)(1) Care and Supervision, Zero Tolerance, cited on 01/23/2025 and 10/30/2025. Facility representatives stated procedures are in place to ensure no child is left without supervision. They stated Staff 2 and 3 did not follow the procedures. Procedures include using a name to face for all children and doing an extra check at the site at dismissal to ensure every child is accounted for. Representatives stated all staff have been retrained on supervision procedures. (1/2) NAME OF LICENSING PROGRAM MANAGER: Mai Lor NAME OF LICENSING PROGRAM ANALYST: Jeremey McClain LICENSING PROGRAM ANALYST SIGNATURE: DATE: 11/14/2025 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/14/2025 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 promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given. CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the l