4TH R - GENEVIEVE DIDION

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) Christopher Bello arrived at approximately 11:45am met with Director, Jake Fernandez, regarding an Unusual Incident that took place June 28th, 2023. LPA made observations and interviewed staff regarding the incident. Staff self-reported the incident to the Sacramento Regional Office. Director stated that they have done training in the past and will conduct another in the near future to prevent incidents like these from happening in the future. Title 22 Deficiencies have been cited on the attached LIC 809D. Upon receipt of Type A citations, facility shall post and provide copies of the LIC 809D for parents/guardians of children currently in care and for parents/guardians of newly enrolled children for the next 12 months. Facility must also keep the signed LIC 9224, Acknowledging Receipt of Licensing Reports LIC 809D in each child's files This report was reviewed and discussed with licensee. A notice of site visit and appeal rights were provided. SUPERVISORS NAME: Amanda Blesi LICENSING EVALUATOR NAME: Christopher Bello LICENSING EVALUATOR SIGNATURE: DATE: 07/07/2023 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/07/2023 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 2 FACILITY NAME: 4TH R - GENEVIEVE DIDION FACILITY NUMBER: 340311928 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 07/07/2023 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type A 07/21/2023 Section Cited CCR 101229(a)(1) 1 2 3 4 5 6 7No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation. This requirement has not been met by evidence: Facility self-reported the incident. This is considered as an1 2 3 4 5 6 7Director stated that they have performed training in the past and will conduct another regarding this incident. LPA will return to clear the deficiency and to review LIC9224. 8 9 10 11 12 13 14immediate risk to the children in care.8 9 10 11 12 13 14 1 2 3 4 5 6 71 2 3 4 5 6 7 1 2 3 4 5 6 71 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:Amanda Blesi LICENSING EVALUATOR NAME:Christopher Bello LICENSING EVALUATOR SIGNATURE: DATE: 07/07/2023 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/07/2023

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) Christopher Bello arrived at approximately 11:45am met with Director, Jake Fernandez, regarding an Unusual Incident that took place June 28th, 2023. LPA made observations and interviewed staff regarding the incident. Staff self-reported the incident to the Sacramento Regional Office. Director stated that they have done training in the past and will conduct another in the near future to prevent incidents like these from happening in the future. Title 22 Deficiencies have been cited on the attached LIC 809D. Upon receipt of Type A citations, facility shall post and provide copies of the LIC 809D for parents/guardians of children currently in care and for parents/guardians of newly enrolled children for the next 12 months. Facility must also keep the signed LIC 9224, Acknowledging Receipt of Licensing Reports LIC 809D in each child's files This report was reviewed and discussed with licensee. A notice of site visit and appeal rights were provided. SUPERVISORS NAME: Amanda Blesi LICENSING EVALUATOR NAME: Christopher Bello LICENSING EVALUATOR SIGNATURE: DATE: 07/07/2023 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/07/2023 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 2 FACILITY NAME: 4TH R - GENEVIEVE DIDION FACILITY NUMBER: 340311928 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 07/07/2023 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type A 07/21/2023 Section Cited CCR 101229(a)(1) 1 2 3 4 5 6 7No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation. This requirement has not been met by evidence: Facility self-reported the incident. This is considered as an1 2 3 4 5 6 7Director stated that they have performed training in the past and will conduct another regarding this incident. LPA will return to clear the deficiency and to review LIC9224. 8 9 10 11 12 13 14immediate risk to the children in care.8 9 10 11 12 13 14 1 2 3 4 5 6 71 2 3 4 5 6 7 1 2 3 4 5 6 71 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:Amanda Blesi LICENSING EVALUATOR NAME:Christopher Bello LICENSING EVALUATOR SIGNATURE: DATE: 07/07/2023 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/07/2023