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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 093603209
Report Date: 01/29/2020
Date Signed: 01/29/2020 12:33:50 PM

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:PLACERVILLE PRESCHOOLERS/KID'S KAMPUSFACILITY NUMBER:
093603209
ADMINISTRATOR:JONES, DEANNAFACILITY TYPE:
850
ADDRESS:6556 COMMERCE WAYTELEPHONE:
(530) 626-2570
CITY:DIAMOND SPRINGSSTATE: CAZIP CODE:
95619
CAPACITY:60CENSUS: 52DATE:
01/29/2020
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Jessica CochraneTIME COMPLETED:
12:45 PM
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Licensing Program Analyst (LPA) Michelle Pascual met with Office Manager Jessica Cochrane for the purpose of an unannounced annual inspection. Upon arrival there were fifty two (52) preschoolers present . The facility is open Monday-Friday 07:00 a.m. to 6:00 p.m. The children bring their own lunches and the facility provides a.m. and p.m. snack.

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. Areas around high climbing equipment had cushioning materials. Storage containers for solid waste had lids. Uncontaminated drinking water is available both indoors and outside. The facility has a working carbon monoxide detector that meets statutory requirements. Facility has a current fire/disaster drill log and the last drill was conducted in 12/2019. Facility has license, parents’ rights, emergency evacuation, and car seat safety posted. FACILITY ADMINISTRATION-All staff present today had a criminal background check clearance. LPA notated that CPR expired 04/20 and Mandatory Reporting Training expired 12/2021.

SUPERVISOR'S NAME: Bettina EngelmanTELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Michelle PascualTELEPHONE: (916) 704-7665
LICENSING EVALUATOR SIGNATURE:

DATE: 01/29/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2020
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: PLACERVILLE PRESCHOOLERS/KID'S KAMPUS
FACILITY NUMBER: 093603209
VISIT DATE: 01/29/2020
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This facility does provide Incidental Medical Services – IMS. 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

Based upon today’s inspection, there were no Title 22 deficiencies today.

SUPERVISOR'S NAME: Bettina EngelmanTELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Michelle PascualTELEPHONE: (916) 704-7665
LICENSING EVALUATOR SIGNATURE:

DATE: 01/29/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2020
LIC809 (FAS) - (06/04)
Page: 2 of 2