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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 093616214
Report Date: 03/21/2023
Date Signed: 03/21/2023 11:02:07 AM


Document Has Been Signed on 03/21/2023 11:02 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:COUNTRY KIDS DAYCARE & PRESCHOOLFACILITY NUMBER:
093616214
ADMINISTRATOR:SPRINGER, ASHLEEFACILITY TYPE:
830
ADDRESS:610 PLEASANT VALLEY ROADTELEPHONE:
(530) 642-1630
CITY:DIAMOND SPRINGSSTATE: CAZIP CODE:
95619
CAPACITY:8CENSUS: 2DATE:
03/21/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Ashlee SpringerTIME COMPLETED:
11:15 AM
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On March 21st, 2023, Licensing Program Analysts (LPAs) Soleil Marx and Jeremey McClain met with Director Ashlee Springer for an unannounced annual inspection. LPA observed a census of two infants being supervised by two staff. Facility hours of operation are Monday through Friday 7:30 AM - 5:30 PM. . All individuals subject to criminal record review have obtained clearance

LPAs inspected all activity and classroom spaces, restrooms, food service, and outdoor play areas. Hazardous items are inaccessible to children. Furniture and equipment are in operable and safe condition. Playground equipment and surfaces are free of loose or sharp parts, shading provided via trees and adequate cushioning was observed in areas underneath climbing equipment. Toileting facilities are in safe, sanitary, and operating condition. The floors appeared clean throughout the facility. The food preparation space is free of litter and all food was protected against contamination. The infants in care bring their own food/bottles from home. Storage containers with solid waste have tight-fitting covers in each classroom. Medications are stored in a central location. LPA observed a functional carbon monoxide detector. Facility uses full legal signatures for sign in/sign out records. Uncontaminated drinking water is readily available to children both indoors and outdoors. LPA observed fire drill log, last drill was conducted on 03/2023.



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. LPA observed appropriate napping equipment for each infant in care. Cribs were equipped with appropriate fitting mattresses, tight fitting covers, and were free of loose articles and objects, including blankets and pillows. LPA observed documented 15 minute sleep checks. Infant bottles were labeled with the date and child’s name. LPA observed Infant sleep plans (LIC 9227) for infants up to 12 months old, as well as Infant needs and services plan that were updated quarterly. (1/2)
SUPERVISOR'S NAME: Natalie DunawayTELEPHONE: (916) 584-3508
LICENSING EVALUATOR NAME: Soleil MarxTELEPHONE: (916) 263-5744
LICENSING EVALUATOR SIGNATURE:
DATE: 03/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/21/2023
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
RIVER CITY (SACTO)CC, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME: COUNTRY KIDS DAYCARE & PRESCHOOL
FACILITY NUMBER: 093616214
VISIT DATE: 03/21/2023
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Children's files were reviewed. Each child's file contained the required documentation. LPA reviewed files for all present staff. At least one staff member present today has current Pediatric CPR and First Aid certification which expires: 10/2023. All staff currently employed with the facility have: a criminal record clearance, a health screening report, immunization records, current AB1207 Mandated Reporter Training, and documentation of their educational background, training, and/or experience.

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.

This Facility has tested their water for excessive amounts of lead and there were no exceedances found.



LPA encouraged the 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 childcare centers. LPA also encouraged the Director to sign up for the Child Care Advocates quarterly newsletter.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

No Title 22 Deficiencies are being cited



This report was reviewed with licensee, and an exit interview was conducted.

A Notice of Site Visit was provided and must remain posted for 30 days. (2/2)
SUPERVISOR'S NAME: Natalie DunawayTELEPHONE: (916) 584-3508
LICENSING EVALUATOR NAME: Soleil MarxTELEPHONE: (916) 263-5744
LICENSING EVALUATOR SIGNATURE:

DATE: 03/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2023
LIC809 (FAS) - (06/04)
Page: 2 of 2