093612133-5-15-2023-03-CC-EPGO-CRUNMK-20230515103515

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 093612133
Report Date: 05/15/2023
Date Signed: 05/15/2023 10:35:22 AM

Document Has Been Signed on 05/15/2023 10:35 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVER CITY (SACTO)CC, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME:	BUCKEYE PRESCHOOL		FACILITY NUMBER:	093612133
ADMINISTRATOR:	HALL/CORE		FACILITY TYPE:	850
ADDRESS:	4561 BUCKEYE ROAD		TELEPHONE:	(530) 677-7216
CITY:	SHINGLE SPRINGS	STATE: CA	ZIP CODE:	95682
CAPACITY:	24	CENSUS: 15	DATE:	05/15/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:35 AM
MET WITH:	Brenda Brown		TIME COMPLETED:	10:45 AM

NARRATIVE

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Licensing Program Analysts Erwina Pascual-Golamco and Jennifer Velasco (LPA) met with Head Teacher Brenda Brown for an unannounced annual inspection. LPA toured the facility, including all activity and classroom spaces, restrooms, and outdoor play areas. Census included 15 preschool children being supervised by 3 classroom staff. Head Teacher was reminded never to exceed the conditions, limitations, and capacity specified on the license.

This site operates on Buckeye Elementary School Campus in Room #3 as a State Preschool Title 5 Program Monday to Friday from 8:30 am to 11:30 am and a Head Start Program from 11:30 am to 3:00 pm following the Buckeye Unified School District calendar. LPA observed a posted menu. The facility provides breakfast, lunch, and afternoon snacks that are delivered with minimal food preparation occurring in the classroom.

Head Teacher 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 are clean, including the carpets and floors, and are free from hazards. Chemicals were kept inaccessible to children. Playground equipment and surfaces were inspected and are in good condition with enough resilient material under climbing structures to cushion fall.

Bathrooms were observed and all sinks and toilets were sanitary and 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. LPA observed all required licensing documentation was posted for parental review. LPA observed that parents are signing their children in and out of the center.

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SUPERVISOR'S NAME: Natalie Dunaway	TELEPHONE: (916) 584-3508
LICENSING EVALUATOR NAME: Erwina Pascual-Golamco	TELEPHONE: (916) 206-1524
LICENSING EVALUATOR SIGNATURE:	DATE: 05/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2023

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
RIVER CITY (SACTO)CC, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: BUCKEYE PRESCHOOL	FACILITY NUMBER: 093612133
	VISIT DATE: 05/15/2023

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Children’s and staff’s files were reviewed. Each child's file had the required licensing documentation. LPA reviewed staff transcripts and observed all staff caring for children were qualified. At least one staff had a current Pediatric CPR and First Aid certification. Staff all have current Mandated Reporter certificates and proof of immunizations. LPA observed a current children's roster and a fire drill log. There is First Aid equipment available.

Incidental Medical Services (IMS) were discussed. For additional IMS information, Head Teacher was advised to 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: http://www.ada.gov/childqanda.htm.

Head Teacher was encouraged to the visit the department's website at WWW.CCLD.CA.GOV for information regarding childcare updates, PINs, forms, regulations and legislation pertaining to childcare centers.

No deficiencies were cited during today's inspection. This report was reviewed with Head Teacher, and an exit interview was conducted. A Notice of Site Visit (NOS) was provided to Head Teacher, who will post it for a period of 30 days for parental review.

SUPERVISOR'S NAME: Natalie Dunaway	TELEPHONE: (916) 584-3508
LICENSING EVALUATOR NAME: Erwina Pascual-Golamco	TELEPHONE: (916) 206-1524
LICENSING EVALUATOR SIGNATURE:	DATE: 05/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2023

LIC809 (FAS) - (06/04)

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