045405067-9-30-2019-13-CC-SHUD-BGHUS6-20190930154950

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 045405067
Report Date: 09/30/2019
Date Signed: 09/30/2019 03:50:00 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME:	MI ESCUELITA MAYA P/S & CHILDRENS PERFORMING ARTS		FACILITY NUMBER:	045405067
ADMINISTRATOR:	TRENDA, MARIA		FACILITY TYPE:	850
ADDRESS:	1455 CHESTNUT STREET		TELEPHONE:	(530) 893-1419
CITY:	CHICO	STATE: CA	ZIP CODE:	95928
CAPACITY:	45	CENSUS: 17	DATE:	09/30/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	02:30 PM
MET WITH:	Cindy Jimenez, Teacher		TIME COMPLETED:	03:55 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	An unannounced annual inspection was made to the facility by Licensing Program Analysts (LPAs) Kirk Marks and Sandy Husband. The facility file was reviewed prior to this inspection. A review of the personnel report on 9/25/19 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. The facility’s operating hours are 8:00 AM - 11:30 AM, 1:30 PM - 4:30 PM, Monday – Friday. The facility was toured inside and outside and the floor and yard plan submitted by the licensee were verified. The items which could pose a danger to children (such as detergents, cleaning compounds and medications) were observed to be inaccessible to children. Poisons are locked in the staff bathroom. The facility was free of flies, insects and rodents. The toys, floors, desks and other equipment and surfaces were clean, toxic free, safe and in good condition. There is uncontaminated drinking water available to children both indoors and outdoors via individual water cups. The children’s bathrooms were in safe and sanitary condition. A current menu was posted in the main classroom. Food prep areas are clean. Food is properly stored and free of contamination. Garbage cans containing solid waste have tight fitting lids. The playground was free of hazards. The playground equipment and surface areas were in safe condition. There is pea gravel cushioning underneath climbing structures and/or play equipment to absorb falls. There were no bodies of water observed. The director's assistant stated no weapons are stored on site and none were observed. There is a working carbon monoxide detector and charged fire extinguisher. An emergency drill was conducted within the past 6 months on 6/11/19. During today's inspection, staffing ratios were being met and there were 17 children being supervised by 4 teachers/aides during indoor activities. The facility was operating within the licensed capacity. At least one staff member present during the visit (S1) possessed current CPR and First Aid certifications which (Continued on LIC 809-C)

SUPERVISOR'S NAME: Megan Aviles	TELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Sandra Husband	TELEPHONE: 530-895-5822
LICENSING EVALUATOR SIGNATURE:	DATE: 09/30/2019

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2019

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

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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, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME: MI ESCUELITA MAYA P/S & CHILDRENS PERFORMING ARTS	FACILITY NUMBER: 045405067
	VISIT DATE: 09/30/2019

NARRATIVE

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(Continued from LIC 809)
expires on 1/21/21. Eight children’s records were reviewed at 2:45 PM, and contained identification forms with authorized representative information, as well as medical assessments. 4 staff records were reviewed at 3:15 PM, and contained health screening forms. The sign in/out procedure was reviewed and missing signatures for two children (C1 and C2). This facility is not providing Incidental Medical Services (IMS) to children. The Department’s IMS policy was discussed with the Director's Assistant. (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: www.ada.gov/childqanda.htm. This report, as well as the AAP Guide to Safe Sleep Practices brochure, were reviewed and discussed with the Director's Assistant. All licensing reports are public information and must be made available upon request for at least three years.

Notice of Site Visit shall be posted for 30 days from today's visit.

The following violation(s) of the California Code of Regulations, Title 22; Division 12, were observed: see LIC 809D. Appeal Rights were provided.

SUPERVISOR'S NAME: Megan Aviles	TELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Sandra Husband	TELEPHONE: 530-895-5822
LICENSING EVALUATOR SIGNATURE:	DATE: 09/30/2019

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2019

LIC809 (FAS) - (06/04)

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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, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME: MI ESCUELITA MAYA P/S & CHILDRENS PERFORMING ARTS	FACILITY NUMBER: 045405067
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/30/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 10/07/2019 Section Cited	1 2 3 4 5 6 7	The person who signs the child in/out shall use his/her full legal signature and shall record the time of day. This requirement was not met as evidence by: based on director failed to ensure the authorize authority for C1 and C2
	8 9 10 11 12 13 14	had signed in and out with full signatures. This poses a potential risk to children in care.	8 9 10 11 12 13 14
	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: Megan Aviles	TELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Sandra Husband	TELEPHONE: 530-895-5822
LICENSING EVALUATOR SIGNATURE:	DATE: 09/30/2019

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2019

LIC809 (FAS) - (06/04)

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