Community Care Licensing

SUPERVISOR'S NAME: Erin Virrueta TELEPHONE: (530) 895-4325 LICENSING EVALUATOR NAME: Kiriko Lynch TELEPHONE: (530) 895-5033 LICENSING EVALUATOR SIGNATURE: DATE: 08/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/11/2022

Document Has Been Signed on 08/11/2022 12:35 PM - It Cannot Be Edited

FACILITY NAME: CHILDREN'S COTTAGE PRESCHOOL, THE	FACILITY NUMBER: 123007037
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/11/2022

Type B

Section Cited

CCR

101174(b)(1)

(b) The plan shall be subject to review by the Department and shall include: (1) Designation of administrative authority and staff assignments. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review of LIC 610, the licensee did not comply with the section cited above in not yet updating staff designations for emergency plan and operations which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 09/12/2022
	Plan of Correction
1 2 3 4	Facility representative stated she will ensure to work with owner/licensee that LIC 610 form is updated along with emergency plan of operations and will provide to Licensing by POC due date.

Type B

Section Cited

CCR

101174(d)(2)

(d) Disaster drills shall be conducted at least every six months. (2) The drills shall be documented. This documentation shall be kept in the child care center for at least one year. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in by not having an updated written record of a disaster drill conducted within the last six months which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 09/12/2022
	Plan of Correction
1 2 3 4	Facility representative stated she will ensure the disaster drills are written down when conducted at least every six months and provide the copy to Licensing by POC due date.

SUPERVISOR'S NAME: Erin Virrueta TELEPHONE: (530) 895-4325 LICENSING EVALUATOR NAME: Kiriko Lynch TELEPHONE: (530) 895-5033 LICENSING EVALUATOR SIGNATURE: DATE: 08/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/11/2022

Document Has Been Signed on 08/11/2022 12:35 PM - It Cannot Be Edited

FACILITY NAME: CHILDREN'S COTTAGE PRESCHOOL, THE	FACILITY NUMBER: 123007037
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/11/2022

Type B

Section Cited

CCR

101238.3(b)

(b) The floors of all rooms shall have a surface that is safe and clean. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation and interviews, the licensee did not comply with the section cited above in kitchen and playroom floors and rug areas were observed to have general dirtiness and interviews revealed no routine janitorial cleaning was conducted recently, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 09/12/2022
	Plan of Correction
1 2 3 4	Facility representative stated she will ensure to discuss cleaning needs with owner/licensee and provide a receipt of cleaning after conducted by janitorial staff and also photo evidence of the areas as clean.

Type B

Section Cited

CCR

101226(d)(1)

(d) The licensee shall maintain the following first-aid supplies in a location accessible to staff but inaccessible to children: (1) A current edition of a first-aid manual. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the licensee did not comply with the section cited above in fist aid kit was missing a current manual which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 09/12/2022
	Plan of Correction
1 2 3 4	Facility representative stated she will ensure to work with owner/licensee to procure and include a current first aid manual for the kit and provide photo to Licensing by POC due date.

SUPERVISOR'S NAME: Erin Virrueta TELEPHONE: (530) 895-4325 LICENSING EVALUATOR NAME: Kiriko Lynch TELEPHONE: (530) 895-5033 LICENSING EVALUATOR SIGNATURE: DATE: 08/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/11/2022

Document Has Been Signed on 08/11/2022 12:35 PM - It Cannot Be Edited

FACILITY NAME: CHILDREN'S COTTAGE PRESCHOOL, THE	FACILITY NUMBER: 123007037
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/11/2022

Type B

Section Cited

CCR

101226(d)(6)

(d) The licensee shall maintain the following first-aid supplies in a location accessible to staff but inaccessible to children: (6) Tweezers. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation and interviews, the licensee did not comply with the section cited above in the first aid kit was missing tweezers which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 09/12/2022
	Plan of Correction
1 2 3 4	Facility representative stated she will work with owner/licensee to procure tweezers for the first aid kit, and send photo to Licensing by POC due date.

Type B

Section Cited

CCR

101238(a)

(a) The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation and interviews, the licensee did not comply with the section cited above in some interior and exterior areas had garbage, dirty surfaces/floors/rugs, temporarily non-working children's toilet which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 09/12/2022
	Plan of Correction
1 2 3 4	Facility representative stated she will work with the owner/licensee to ensure all of these issues are addressed and fixed by the POC due date and provide photos to Licensing by then.

SUPERVISOR'S NAME: Erin Virrueta TELEPHONE: (530) 895-4325 LICENSING EVALUATOR NAME: Kiriko Lynch TELEPHONE: (530) 895-5033 LICENSING EVALUATOR SIGNATURE: DATE: 08/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/11/2022

Document Has Been Signed on 08/11/2022 12:35 PM - It Cannot Be Edited

FACILITY NAME: CHILDREN'S COTTAGE PRESCHOOL, THE	FACILITY NUMBER: 123007037
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/11/2022

Type B

Section Cited

CCR

101238(g)

(g) Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children shall be stored where inaccessible to children. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the licensee did not comply with the section cited above in a container of pine scented cleaning liquid was found on the kitchen floor behind an unlatched gate which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 09/12/2022
	Plan of Correction
1 2 3 4	Facility representative stated she will ensure gate is always latched and work with owner/licensee to provide a refresher training to all current and new staff regarding appropriate methods of storing and using cleaning products and provide written statement with meeting agenda to Licensing by POC due date.

Type B

Section Cited

CCR

101220(a)

(a) Prior to, or within 30 calendar days following the enrollment of a child, the licensee shall obtain a written medical assessment of the child. This medical assessment enables the licensee to assess whether the center can provide necessary health-related services to the child. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation and record review, the licensee did not comply with the section cited above in several children's files were missing medical assessments which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 09/12/2022
	Plan of Correction
1 2 3 4	Facility representative stated she will work with owner/licensee to ensure all children's files include necessary documentation including medical assessments and provide photos to Licensing by POC due date

SUPERVISOR'S NAME: Erin Virrueta TELEPHONE: (530) 895-4325 LICENSING EVALUATOR NAME: Kiriko Lynch TELEPHONE: (530) 895-5033 LICENSING EVALUATOR SIGNATURE: DATE: 08/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/11/2022

Document Has Been Signed on 08/11/2022 12:35 PM - It Cannot Be Edited

FACILITY NAME: CHILDREN'S COTTAGE PRESCHOOL, THE	FACILITY NUMBER: 123007037
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/11/2022

Type B

Section Cited

CCR

101229.1(c)

(c) A person who removes the child from the center during the day, and returns the child to the center the same day, shall sign the child in/out. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation and record review, the licensee did not comply with the section cited above in which staff signed child in or out if a parent/guardian did not that day which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 09/12/2022
	Plan of Correction
1 2 3 4	Facility representative stated she will work with owner/licensee to develop a staff method to ensure parents/guardians sign in/out their child/ren every day or will mark as parent/guardian signature needed and obtain signature the next day from parents if they forget, and provide written method to Licensing by POC due date.

Type B

Section Cited

CCR

101227(a)(18)

(18) All kitchen, food-preparation and storage areas shall be kept clean and free of litter and rubbish; and measures shall be taken to keep all such areas free of rodents and other vermin. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the licensee did not comply with the section cited above in kitchen area had dirty stove and fridge and kitchen sink was full of dirty dishes which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 09/12/2022
	Plan of Correction
1 2 3 4	Facility representative stated she will work with owner/licensee to develop and implement an appropriate general daily cleaning schedule that would not conflict with regulatory requirements that cleaning duties should not take away from general care and supervision time for children in care, and provide in writing to Licensing by the POC due date.

SUPERVISOR'S NAME: Erin Virrueta TELEPHONE: (530) 895-4325 LICENSING EVALUATOR NAME: Kiriko Lynch TELEPHONE: (530) 895-5033 LICENSING EVALUATOR SIGNATURE: DATE: 08/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/11/2022