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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 093614561
Report Date: 11/22/2019
Date Signed: 11/22/2019 01:28:40 PM

COMPREHENSIVE INSPECTION
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:HIS KIDS CHRISTIAN PRESCHOOLFACILITY NUMBER:
093614561
ADMINISTRATOR:KALLABIS, CINDRAFACILITY TYPE:
850
ADDRESS:6189 MOTHER LODE DR.TELEPHONE:
(530) 626-2575
CITY:PLACERVILLESTATE: CAZIP CODE:
95667
CAPACITY:30CENSUS: 16DATE:
11/22/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Cindra KallabisTIME COMPLETED:
02:00 PM
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Licensing Program Analyst (LPA) Kelly Ferrara met with Director Cindra Kallabis for the purpose of an unannounced random annual inspection. LPA toured the facility including all activity and classroom spaces, restrooms, food service and outdoor play areas. Appropriate ratio and care and supervision were observed during today's inspection. Census included 16 preschool children being supervised by four staff. Director was reminded never to exceed the conditions, limitations and capacity specified on the license. Facility hours of operation are Monday through Friday from 8:30 AM - 12:30 PM. Director stated on Monday and Wednesday afternoons there are enrichment programs and the facility is open until 2 PM.

Classrooms all appeared clean including the carpets and floor. Playground equipment and surfaces are free of loose or sharp parts, there is enough cushioned material to absorb a fall, and there is adequate shade. Uncontaminated drinking water was readily available to children both indoors and outdoors. 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 a functioning smoke and carbon monoxide detector. Menus were posted for snack and children bring their own lunches from home. All required licensing documentation was posted for parental review. LPA observed where parents are signing their children in and out of the center. Chemical cleaning products were stored inaccessible to children in locked cabinets.

A sample of children and staff files were reviewed. Each child's file had the required licensing documentation. LPA advised that there is a new Public Health form required for Immunization records beginning in January 2020. All staff are qualified teachers, have proof of immunizations, and have the required Mandated Reporter training certification. LPA advised that this must be completed every two years. At least one staff had a current Pediatric CPR and First Aid certification that expires in August 2021. LPA observed a current children's roster and fire drill log with the last drill conducted in November 2019.

SUPERVISOR'S NAME: Bettina EngelmanTELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Kelly FerraraTELEPHONE: (916) 425-5932
LICENSING EVALUATOR SIGNATURE:

DATE: 11/22/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/22/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 2
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: HIS KIDS CHRISTIAN PRESCHOOL
FACILITY NUMBER: 093614561
VISIT DATE: 11/22/2019
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Incidental Medical Services (IMS) policy was discussed with the Director. For additional IMS information, director 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.

This facility evaluation report was reviewed and discussed with the Director. The Director 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 to child care centers. LPA gave the Director a copy of the Effects of Lead Exposure brochure. LPA discussed with the Director Assembly Bill 2370, which will require licensed Child Care Facilities to test their water for excessive amounts of lead. Testing will be required beginning January 1, 2020.

A notice of site visit was provided and should remain posted for a period of 30 days for parental review.

There were no citations issued based on today's inspection.

SUPERVISOR'S NAME: Bettina EngelmanTELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Kelly FerraraTELEPHONE: (916) 425-5932
LICENSING EVALUATOR SIGNATURE:

DATE: 11/22/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/22/2019
LIC809 (FAS) - (06/04)
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