173009810-8-7-2019-01-CC-CARD-BETN6C-20190807101054

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 173009810
Report Date: 08/07/2019
Date Signed: 08/07/2019 10:11:01 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928

FACILITY NAME:	LAKEPORT CHRISTIAN CENTER PS/DAYCARE		FACILITY NUMBER:	173009810
ADMINISTRATOR:	MARY PAARSCH		FACILITY TYPE:	840
ADDRESS:	455 SOUTH FORBES STREET		TELEPHONE:	(707) 262-5520
CITY:	LAKEPORT	STATE: CA	ZIP CODE:	95453
CAPACITY:	30	CENSUS: 0	DATE:	08/07/2019
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	08:15 AM
MET WITH:	Jenna James		TIME COMPLETED:	10:25 AM

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	A Pre-licensing inspection was made to the facility by Licensing Program Analyst (LPA) Chris Arnhold in response to an application received by the Department on 7/9/19 requesting a preschool license for a capacity of 18. LPA met with Lead Teacher Jenna James. The approved fire clearance for the requested capacity was received on 07/22/2019. Services will be provided Monday - Friday; Summer hours, 7:30AM - 5:30PM and school year hours, 2:30PM – 5:30PM. The building was toured, inspected, and measured for space. Indoor useable space measured sufficient for a capacity of 18. The staff restroom/office has been designated as the isolation area. The required postings (Parents/Personal Rights, Emergency Disaster Plan, etc.) is posted by the entry/exit door. Individual storage space was available for children to use. The sign-in and sign-out procedure will be completed on a sign in book located at the front entrance. The applicant understands that full parent/guardian signatures are required. There are 4 toilets and 5 sinks available for children's use. Drinking water was available inside and outside the facility. Poisons are not stored on the premises and none were observed during the inspection; poisons shall be locked via key or combination. There is a working smoke detector, fire extinguisher and carbon monoxide detector in the facility. Items that could pose a danger to children (cleaning compounds, medication, etc) will be inaccessible. The facility will provide AM/PM snacks. Children will bring lunch from home. The play yard is in the front of the facility and is fully fenced. The play yard measured sufficient for a capacity of 346. The children will use a designated playground as the outdoor play area. There is sufficient pea gravel cushioning material under climbing structures and slides. Use of equipment by children shall be age appropriate. Sufficient outdoor shade was available. There are no bodies of water located on the property, and none are to be added without prior notification and approval of the Licensing agency.

SUPERVISOR'S NAME: Leslie Lepori	TELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Christopher Arnhold	TELEPHONE: (707) 588-5056
LICENSING EVALUATOR SIGNATURE:	DATE: 08/07/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2019

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, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928

FACILITY NAME: LAKEPORT CHRISTIAN CENTER PS/DAYCARE	FACILITY NUMBER: 173009810
	VISIT DATE: 08/07/2019

NARRATIVE

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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 http://www.ada.gov/childqanda.htm.

This report, as well as the AAP Guide to Safe Sleep Practices brochure, were reviewed and discussed with the applicant. All licensing reports are public information and must be made available upon request for at least three years.

The facility is ready for licensure with an effective date of 08/08/2019.

SUPERVISOR'S NAME: Leslie Lepori	TELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Christopher Arnhold	TELEPHONE: (707) 588-5056
LICENSING EVALUATOR SIGNATURE:	DATE: 08/07/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2019

LIC809 (FAS) - (06/04)

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