090320884-10-27-2022-03-CC-AMAT-CKLUAP-20221027152503

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 090320884
Report Date: 10/27/2022
Date Signed: 10/27/2022 03:25:09 PM

Document Has Been Signed on 10/27/2022 03:25 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, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME:	EL DORADO COUNTY FEDERATED CHURCH PRESCHOOL		FACILITY NUMBER:	090320884
ADMINISTRATOR:	REEVES,KELLY		FACILITY TYPE:	850
ADDRESS:	1031 THOMPSON WY		TELEPHONE:	(530) 622-5226
CITY:	PLACERVILLE	STATE: CA	ZIP CODE:	95667
CAPACITY:	43	CENSUS:	DATE:	10/27/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:05 PM
MET WITH:	Janell Palmer		TIME COMPLETED:	03:50 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	On Thursday October 27th, 2022, Licensing Program Analyst (LPA) Arianna Manabat met with Janell Palmer for an unannounced annual inspection. At 2:30 PM, LPA toured the facility including all activity and classroom spaces, restrooms, food service and outdoor play areas. Census included 28 preschool children in care with 4 staff. Director was reminded never to exceed the conditions, limitations and capacity specified on the license. Facility hours of operation are 7:30AM to 5:30PM. Facility Representative 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. Classrooms all appeared clean including the carpets and floor. Chemicals and cleaning materials were kept inaccessible to children. Playground equipment and surfaces were inspected and are in good condition with enough resilient material under climbing structures to absorb a fall. Drinking water was readily available to children both indoors and outdoors via water cups and water bottles. Shade was provided via trees. Bathrooms were clean and all sinks and toilets were in operating condition. There are no firearms or bodies of water on the premises and the facility has at least one functioning smoke and carbon monoxide detector. Menus were posted for AM and PM snack. LPA observed the appropriate postings were visible to parents. LPA observed a current children's roster and a fire/disaster drill log. Last drill was conducted in September 2022 The facility is equipped with First Aid equipment. LPA observed that parents are signing their children in and out of the center. LPA observed the sample of children’s files contained the appropriate documentation. *Continued on LIC 809-C.....*

SUPERVISOR'S NAME: Natalie Dunaway	TELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Arianna Manabat	TELEPHONE: (279) 200-2886
LICENSING EVALUATOR SIGNATURE:	DATE: 10/27/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2022

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: EL DORADO COUNTY FEDERATED CHURCH PRESCHOOL	FACILITY NUMBER: 090320884
	VISIT DATE: 10/27/2022

NARRATIVE

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LPA reviewed staff files and transcripts and observed that staff being utilized as teachers were qualified. At least one staff had a current Pediatric CPR and First Aid certification which expires February 2024.

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

To improve the quality and value of the new inspection process, a survey may 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/inspection-process.

Facility Representative was encouraged to the visit the Department's website at WWW.CCLD.CA.GOV for information regarding child care updates, PINs, forms, regulations and legislation pertaining to child care centers.

No citations were issued based on today’s inspection. Exit interview was conducted and report was reviewed with the Facility Representative. A notice of site visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Natalie Dunaway	TELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Arianna Manabat	TELEPHONE: (279) 200-2886
LICENSING EVALUATOR SIGNATURE:	DATE: 10/27/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2022

LIC809 (FAS) - (06/04)

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