093616214-11-18-2021-03-CC-JMCN-C8VUXC-20211118145806

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 093616214
Report Date: 11/18/2021
Date Signed: 11/18/2021 02:58:13 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:	COUNTRY KIDS DAYCARE & PRESCHOOL		FACILITY NUMBER:	093616214
ADMINISTRATOR:	SPRINGER, ASHLEE		FACILITY TYPE:	830
ADDRESS:	610 PLEASANT VALLEY ROAD		TELEPHONE:	(530) 642-1630
CITY:	DIAMOND SPRINGS	STATE: CA	ZIP CODE:	95619
CAPACITY:	8	CENSUS: 6	DATE:	11/18/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:45 PM
MET WITH:	Ashlee Springer		TIME COMPLETED:	03:00 PM

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On 11/18/2021, Licensing Program Analyst (LPA) Jeremey McClain met with Director Ashlee Springer for the purpose of an unannounced annual random inspection. LPA observed six infants supervised by two teachers.

LPA toured the building including all activity and classroom spaces, restrooms, food service, and outdoor play areas. No children in care currently require medications Toxic and hazardous items are inaccessible to children. Furniture and equipment are in good condition. Playground equipment and surfaces are free of loose or sharp parts. Infant changing tables have a padded surface that is washable and at least one-inch-thick, and the changing tables have raised sides that are at least three inches high. The floors appeared clean throughout the facility. The food preparation space is free of litter and all food was protected against contamination. Storage containers with solid waste have tight-fitting covers. LPA observed full legal signatures while reviewing the sign in and sign out sheet.

Staff and children's records were reviewed. Each child's file contained an emergency card, a medical assessment, and Infant Needs and Services Plan. LPA reminded director that Needs and Services Plans should be updated quarterly. LPA observed completed sleep plans, and a log of 15 minute checks. At least one staff member present today has current Pediatric CPR and First Aid certification (exp. 10/2023). All staff currently employed with the facility have a criminal record clearance, health screening report, and documentation of the educational background, training, and/or experience. LPA observed functional smoke and carbon monoxide detectors.

LPA reminded the Director that the AB1207 Mandated Reporter Training must be renewed once every two years. LPA provided the website for staff to complete the training at http://childcare.mandatedreporterca.com/

Report continued on the following page...

SUPERVISOR'S NAME: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Jeremey McClain	TELEPHONE: (916) 216-7801
LICENSING EVALUATOR SIGNATURE:	DATE: 11/18/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2021

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: COUNTRY KIDS DAYCARE & PRESCHOOL	FACILITY NUMBER: 093616214
	VISIT DATE: 11/18/2021

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Incidental Medical Services (IMS) policy was discussed. No children in care currently require IMS. 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.

Director was encouraged to the visit the Department's website at WWW.CDSS.CA.GOV for information regarding childcare updates, forms, regulations and legislation pertaining child care centers.

This facility evaluation report was reviewed and discussed with Director.

A Notice of Site Visit was provided and should remain posted for a period of 30 days for parental review.

An exit interview was conducted and in the areas that were evaluated, no deficiencies were observed at the time of the inspection.

SUPERVISOR'S NAME: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Jeremey McClain	TELEPHONE: (916) 216-7801
LICENSING EVALUATOR SIGNATURE:	DATE: 11/18/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2021

LIC809 (FAS) - (06/04)

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