061308899-1-25-2023-13-CC-LCHZ-CNESXG-20230125131556

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 061308899
Report Date: 01/25/2023
Date Signed: 01/25/2023 01:16:02 PM

Document Has Been Signed on 01/25/2023 01:16 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, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME:	OUR LADY OF LOURDES PRESCHOOL		FACILITY NUMBER:	061308899
ADMINISTRATOR:	HODGES, SUSAN		FACILITY TYPE:	850
ADDRESS:	741 WARE AVENUE		TELEPHONE:	(530) 458-8208
CITY:	COLUSA	STATE: CA	ZIP CODE:	95932
CAPACITY:	21	CENSUS: 4	DATE:	01/25/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Susan Hodges		TIME COMPLETED:	01:15 PM

NARRATIVE

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On 1/25/2023 at 9:30 AM, a Required 1 Yearl inspection was made to the facility by Licensing Program Analyst (LPA), Laura Chavez. The facility operates during the traditional school year, 8:00am - 3:00pm, Monday–Friday. The facility was toured at 9:50 AM inside and outside and the floor and yard plan submitted by the licensee were verified. The Director was supervising 4 children, and operating within the licensed capacity and ratio requirements. There are no pools or bodies of water on the premises.The outdoor activity space was cushioned with grass and bark and free of hazards. Five children’s files were reviewed at 11:05am and 1 staff file was reviewed at 10:30 am. CPR/First Aide and Mandated Reporter Training for staff have expired.

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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. 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

Report continued see: LIC809C

SUPERVISOR'S NAME: Megan Aviles	TELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Laura Chavez	TELEPHONE: (530) 895-5914
LICENSING EVALUATOR SIGNATURE:	DATE: 01/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/25/2023

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: OUR LADY OF LOURDES PRESCHOOL	FACILITY NUMBER: 061308899
	VISIT DATE: 01/25/2023

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The following deficiency was cited: a review of file for S1 revealed that training in pediatric CPR/ and first aid is expired (see LIC 809D):

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with Director Susan Hodges.

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 inspectionprocess@dss.ca.gov. 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

SUPERVISOR'S NAME: Megan Aviles	TELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Laura Chavez	TELEPHONE: (530) 895-5914
LICENSING EVALUATOR SIGNATURE:	DATE: 01/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/25/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 01/25/2023 01:16 PM - It Cannot Be Edited

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: OUR LADY OF LOURDES PRESCHOOL	FACILITY NUMBER: 061308899
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/25/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101216(f)

Personnel Requirements

(f) At least one staff member who is trained in pediatric cardiopulmonary resuscitation and pediatric first aid pursuant to Health and Safety Code Section 1596.866 shall be present when children are at the child care center or offsite for center activities. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on staff record review, the facility Director did not comply with the section cited above which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 02/24/2023
	Plan of Correction
1 2 3 4	The facility Director agrees to provide proof of current CPR/First Aide training. The plan of correction shall be submitted to CCLD on or before 2/24/2023.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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: Laura Chavez	TELEPHONE: (530) 895-5914
LICENSING EVALUATOR SIGNATURE:	DATE: 01/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/25/2023

LIC809 (FAS) - (06/04)

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