093615283-11-22-2019-03-CC-KFEA-BJ6PHQ-20191122102019

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 093615283
Report Date: 11/22/2019
Date Signed: 11/22/2019 10:20:25 AM

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:	JACKSON PRESCHOOL		FACILITY NUMBER:	093615283
ADMINISTRATOR:	MILLER, MICHELLE		FACILITY TYPE:	850
ADDRESS:	2561 FRANCISCO DRIVE		TELEPHONE:	(916) 677-2875
CITY:	EL DORADO HILLS	STATE: CA	ZIP CODE:	95762
CAPACITY:	24	CENSUS: 13	DATE:	11/22/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Kelly Lizardo		TIME COMPLETED:	10:30 AM

NARRATIVE

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Licensing Program Analyst (LPA) Kelly Ferrara met with Lead Teacher Kelly Lizardo for the purpose of an unannounced random annual inspection. The preschool operates in classroom C2 on the Jackson Elementary school campus. All staff receive fingerprint clearance through the school district. Appropriate ratio and care and supervision were observed during today's inspection. Census included 13 preschool children being supervised by four staff. Lead Teacher was reminded never to exceed the conditions, limitations and capacity specified on the license. The program operates Monday through Friday 8:45 AM- 12:15 PM.

LPA toured the classroom and outdoor play area. There is a waiver on file to share use of the Kindergarten playground and school restrooms. The program provides a snack and the menu was posted. Other Licensing documentation was posted including Parents Rights, Personal Rights, Carseat laws, Emergency Disaster Plan, and Activities Calendar. The classroom appeared clean and in good repair and the playground equipment and surfaces were inspected and safe. The areas around or under the climbing equipment are cushioned with a resilient 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. The classroom has a functional smoke and carbon monoxide detector. LPA observed a cubby available for each child and a binder for the parents to sign their children in and out of the facility. Chemical cleaning products were stored inaccessible to children in a locked cabinet.

A sample of children and staff files were reviewed. All children's files contained Personal and Parents Rights signed, Immunization record, and all other required information was provided on their own specific forms. Staff files contained the required documentation and each staff has completed the Mandated Reporter training through Works International. At least one staff present today has current Pediatric CPR and First Aid certification that expires in November 2021. LPA observed a current children's roster and a fire drill was conducted on November 15th, 2019.

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Kelly Ferrara	TELEPHONE: (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)

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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: JACKSON PRESCHOOL	FACILITY NUMBER: 093615283
	VISIT DATE: 11/22/2019

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Incidental Medical Services (IMS) is provided by the facility although there are currently no children enrolled with medication. The facility has a first aid box with ample supplies. 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.

The facility evaluation report was reviewed and discussed with the Lead Teacher. LPA encouraged the teacher 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. A notice of site visit was provided and should remain posted for a period of 30 days for parental review.

Based on today's inspection, there were no deficiencies cited.

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Kelly Ferrara	TELEPHONE: (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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