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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 090309074
Report Date: 01/17/2020
Date Signed: 01/17/2020 10:29:31 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:GEORGETOWN HEAD STARTFACILITY NUMBER:
090309074
ADMINISTRATOR:ENGLISH, MARIAFACILITY TYPE:
850
ADDRESS:HARKNESS STREETTELEPHONE:
(530) 333-2039
CITY:GEORGETOWNSTATE: CAZIP CODE:
95634
CAPACITY:22CENSUS: DATE:
01/17/2020
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Maria EnglishTIME COMPLETED:
10:45 AM
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Licensing Program Analyst (LPA) Michelle Pascual met with Site Supervisor Maria English for an unannounced annual random inspection. Upon arrival, three (3) children were present. The center is open Monday-Friday and operates as a Head Start Program from 8:00 am to 11:30 and and serves Breakfast and Lunch; the State Preschool is from 11:30 am to 3:00 pm and serves snack.The facility operates as a traditional school calendar. LPA toured the facility inside and out for a health and safety inspection. PHYSICAL PLANT-The facility appeared orderly and suitable for children. Cleaning supplies and hazardous items were inaccessible to children. Medications are stored in a safe place inaccessible to children in care. Outdoor activity space and equipment was in good repair. Uncontaminated drinking water is available both indoors and outside. LPA observed a first aid kit. LPA observed that solid waste bins had tight-fitting covers on and were in good repair. LPA observed a current fire/disaster drill log. Facility has license, parents’ rights, emergency evacuation, and car seat safety posted. EVALUATION OF CARE AND SUPERVISION- Visual supervision was observed during the visit. Capacity and ratio requirements were being met. FACILITY RECORDS REVIEW- Children’s records included admission agreements. Staff records included a current CPR/First Aide expires 7/16/20 and mandated reporter expires 9/1/21.Staff records contain appropriate documentation of education credits.
SUPERVISOR'S NAME: Bettina EngelmanTELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Michelle PascualTELEPHONE: (916) 704-7665
LICENSING EVALUATOR SIGNATURE:

DATE: 01/17/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2020
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, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME: GEORGETOWN HEAD START
FACILITY NUMBER: 090309074
VISIT DATE: 01/17/2020
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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

The facility evaluation report was reviewed and discussed with the licensee. A notice of site visit was provided and should remain posted for a period of 30 days for parental review. Site Supervisor was encouraged to the visit the department’s website at WWW.CCLD.CA.GOV for information regarding child care updates, forms, regulations and legislation pertaining child care centers.



Based upon today’s inspection, no Title 22 deficiencies were cited.
SUPERVISOR'S NAME: Bettina EngelmanTELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Michelle PascualTELEPHONE: (916) 704-7665
LICENSING EVALUATOR SIGNATURE:

DATE: 01/17/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2020
LIC809 (FAS) - (06/04)
Page: 2 of 2