093616215-3-4-2020-03-CC-MPAL-BMDV5H-20200304150757

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 093616215
Report Date: 03/04/2020
Date Signed: 03/04/2020 03:08:02 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:	093616215
ADMINISTRATOR:	SPRINGER, ASHLEE		FACILITY TYPE:	850
ADDRESS:	610 PLEASANT VALLEY ROAD		TELEPHONE:	(530) 642-1630
CITY:	DIAMOND SPRINGS	STATE: CA	ZIP CODE:	95619
CAPACITY:	28	CENSUS: 16	DATE:	03/04/2020
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:05 PM
MET WITH:	Ashlee Springer		TIME COMPLETED:	03:30 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analysts (LPAs), Christopher Jackson and Michelle Pascual conducted an unannounced random annual inspection today. LPAs met with Director, Ashlee Springer. Upon arrival at 01:05PM, inspection, there were 16 preschool children in attendance with two teachers in the room. A tour of the facility was conducted inside and outside. The preschool area are in compliance during the visit. There are no bodies of water. Firearms and ammunition are not on the premises. Disinfectants, hazardous items and medications are inaccessible to children. Furniture and equipment are sufficient, age appropriate and in good repair. Fire drills are conducted and documented. Carbon Monoxide/smoke detectors and a working fire extinguisher were observed and in compliance. The playground equipment and outdoor activity space is maintained and in good condition. Wood chips are being used as cushioning around the climbing equipment and level is sufficient to absorb a fall. Children's toilets, hand washing facilities are sanitary. Floors are clean and free of debris. Food preparation area is clean, food is protected from contamination, storage containers for solid waste are covered and all food or beverages are stored in covered containers and labeled. Drinking water is available both indoors and outdoors. Menus are posted. The facility is in compliance with conditions and limitations specified on the license. Sign in/sign out sheets are maintained. Four children’s files were reviewed. All files were completed with required licensing documents. No excluded individuals are present. Staff subject to a criminal record clearance or exemption are associated to the facility. LPAs observed First Aid/CPR certification for Director expired on 04/2021 and Mandatory Reporter Training expires 03/22/2021. Emergency information was reviewed. Fire drills are current. Operating hours are Monday thru Friday; 6:30 AM to 6:00 PM. This facility does not provide Incidental Medical Services (IMS) however the policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Michelle Pascual	TELEPHONE: (916) 704-7665
LICENSING EVALUATOR SIGNATURE:	DATE: 03/04/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2020

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: 093616215
	VISIT DATE: 03/04/2020

NARRATIVE

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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.

LPA discussed the new Mandated Reporter Training with licensee. Beginning January 1, 2018, Health and Safety Code 1596.8662 requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Volunteers are encouraged but not required to take the training. In addition, existing staff must meet requirements by March 30, 2018. This training requirement may be met by using the Department’s Office of Child Abuse Prevention (OCAP) online training modules. The OCAP modules are free of cost and available at: http://www.mandatedreporterca.com/. The training is currently provided in English.

LPA also discussed the Effects of Lead Exposure with licensee.

LPA provided the Community Care Licensing’s website www.ccld.ca.gov, so the licensee can obtain updated licensing information, new regulations and access forms. LPA advised licensee of their responsibility to stay current in regards to new regulations. LPA also included the email address for the children's advocacy program to stay current on new laws childcareadvocatesprogram@dss.ca.gov.

Based on today's visit no title 22 deficiencies were observed

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Michelle Pascual	TELEPHONE: (916) 704-7665
LICENSING EVALUATOR SIGNATURE:	DATE: 03/04/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2020

LIC809 (FAS) - (06/04)

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