210102877-1-15-2020-05-CC-KOCL-BKUTTE-20200115140037

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 210102877
Report Date: 01/15/2020
Date Signed: 01/15/2020 02:00:48 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	NOVATO PARENTS NURSERY SCHOOL, INC		FACILITY NUMBER:	210102877
ADMINISTRATOR:	MELISSA ETCHEVERRY		FACILITY TYPE:	850
ADDRESS:	1473 SOUTH NOVATO BOULEVARD		TELEPHONE:	(415) 897-4498
CITY:	NOVATO	STATE: CA	ZIP CODE:	94947
CAPACITY:	26	CENSUS: 5	DATE:	01/15/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	12:20 PM
MET WITH:	Melissa Etcheverry		TIME COMPLETED:	02:15 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	A annual inspection was made to the facility by Licensing Program Analyst (LPA) Kevin O'Connell. The facility file was reviewed prior to this visit. A review of the personnel report on 01/15/20 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. This program operates Monday - Friday; 9:00 am to 3:00 pm. The facility was toured at 012:35pm and the floor and yard plan submitted by the licensee were verified. This facility is licensed for 26 children. 1 teacher was supervising 5 children during today's inspection and were operating within the licensed capacity and ratio requirements. The items which could pose a danger to children (such as detergents, cleaning compounds and medications) were observed to be inaccessible to children. The Director states that there are no poisons but knows to lock them. The toys, floors, desks and other equipment and surfaces are clean, toxic free, safe and in good condition. There is uncontaminated drinking water available to children both indoors and outdoors on the playground. The children's bathrooms are in safe and sanitary condition. Food prep areas are clean. Children bring their own lunch. Snacks are served and menus were posted. Garbage containers containing solid waste have tight fitting lids. The LPA observed a working carbon monoxide detector and there were charged fire extinguishers of at least 2A 10: BC or larger. The playground was free of hazards. The playground equipment was in safe condition. There is bark for cushioning underneath the climbing structures to absorb falls. The Director stated that there are no bodies of water and none were observed. The Director stated no weapons are stored on site and none were observed. Multiple teachers had current Pediatric CPR and First Aid certifications on file.

SUPERVISOR'S NAME: Leslie Lepori	TELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Kevin O'Connell	TELEPHONE: (707) 588-5047
LICENSING EVALUATOR SIGNATURE:	DATE: 01/15/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2020

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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: NOVATO PARENTS NURSERY SCHOOL, INC	FACILITY NUMBER: 210102877
	VISIT DATE: 01/15/2020

NARRATIVE

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The sign-in/sign-out procedure was reviewed and in compliance. Two staff records were reviewed at 01:05pm for immunizations, Mandated Reporter Certificates. Ten children’s records were reviewed at 12:05pm, and contained signed admission agreements.
This facility provides Incidental Medical Services – IMS (Epi-pen). LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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 report, as well as the AAP Guide to Safe Sleep, Safe Sleep in Childcare brochure, What does a Safe Sleep Environment Look Like brochure & Safe Sleep Concepts handout, were reviewed and discussed with the Director. The Effects of Lead Exposure brochure has been reviewed with and discussed with the Director. All licensing reports are public information and must be made available upon request for at least three years. No deficiencies were cited today.

Notice of Site Visit shall be posted for 30 days from today's visit.

SUPERVISOR'S NAME: Leslie Lepori	TELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Kevin O'Connell	TELEPHONE: (707) 588-5047
LICENSING EVALUATOR SIGNATURE:	DATE: 01/15/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2020

LIC809 (FAS) - (06/04)

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