210105564-1-4-2022-05-CC-HRCO-CACVYT-20220104155137

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 210105564
Report Date: 01/04/2022
Date Signed: 01/04/2022 03:51:51 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:	NOAH'S ARK PRESCHOOL		FACILITY NUMBER:	210105564
ADMINISTRATOR:	RUTH ANN NEWBERRY		FACILITY TYPE:	850
ADDRESS:	1370 SOUTH NOVATO BOULEVARD		TELEPHONE:	(415) 892-8498
CITY:	NOVATO	STATE: CA	ZIP CODE:	94947
CAPACITY:	100	CENSUS: 59	DATE:	01/04/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:06 PM
MET WITH:	Heather Freeman & Ruth Ann Newberry		TIME COMPLETED:	03:00 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 Analyst (LPA) Haydee Caliboso met with the Assistant Supervisor, Heather Freeman and Director Ruth Ann Newberry to conduct an unannounced annual inspection on 01/04/22. LPA arrived at the facility at 12:05PM. The purpose of the inspection was explained. Present during the inspection were 59 children and 10 staff. Facility is operating within the capacity and is following staff child ratio. LPA observed that the program is operating within ratio on this day. The facility operates Monday – Friday, 7:00 AM to 6:00 PM. The facility was inspected today, indoors and outdoors for health and safety hazards. LPA observed no bodies of water at the facility. Director stated there are no firearms or weapons in the facility. The facility is equipped with smoke detector, carbon monoxide detectors, fully charged fire extinguishers and a working telephone available. The classrooms have adequate ventilation and lighting. LPA observed all cleaning solutions, poisons and other chemicals that are dangerous to the children are stored made inaccessible to the children. The classrooms are equipped with age-appropriate toys and furniture. The furniture is steady and in good repair. Facility floor is in good repair and free of any hazards. LPA observed toilets and hand washing equipment are in working condition with proper sanitation in place. All storage containers for solid waste and in good repair and have proper tight fitted lid on top. The program has drinking water available for children for indoors and outdoors. The Assistant Director stated the children in the program brings their own water bottle. 809-C pg. 2 Cont.

SUPERVISOR'S NAME: Cindy Interiano	TELEPHONE: (650)266-8864
LICENSING EVALUATOR NAME: Haydee R Caliboso	TELEPHONE: (650)266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 01/04/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/04/2022

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: NOAH'S ARK PRESCHOOL	FACILITY NUMBER: 210105564
	VISIT DATE: 01/04/2022

NARRATIVE

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Outdoor play structures are age appropriate and in good working condition, free of loose parts, free of hazard, and with sufficient cushion underneath. First aid kit and emergency supplies are properly maintained and kept inaccessible to children. Assistant Director stated that there is one child who currently have medication in placed while in care. LPA observed medication is current, kept in original container, and consent form is kept in file. LPA observed medication cabinet is locked and made inaccessible to children.

LPA reviewed personnel and children’s files during today’s inspection. LPA observed all files are complete and up-do-date. LPA observed facility has record of names, addresses and telephone numbers of each child 's authorized representative. Each child's record contains the record immunization. Multiple staff members have record of valid CPR card in file. LPA reviewed the educational qualification of all the teachers. Facility has a log for emergency drills being conducted. Per log, last emergency drill was conducted on 12/17/21. Per Assistant Director the program is currently not providing transportation.

LPA reminded the Director that as of September 1, 2016, a person may not be employed or volunteer at a childcare facility unless he or she has been immunized against influenza, pertussis, and measles or qualifies for an exemption pursuant to Health and Safety code 1596.7995 and 1597.662. The Director was reminded about Mandated Reporter training available on the CCLD website. In addition to the AB1207 training that must be completed every two years by all staff hired, a one-time General Training is also required. Training can be taken online at www.mandaterreporterca.com. LPA observed multiple staff have completed the child abuse training. Director and Assistant Director was reminded of Pesticides training. Information on the DPR website at: www.cdpr.ca.gov/shoolipm/childcare

809-C pg. 3 Cont.

SUPERVISOR'S NAME: Cindy Interiano	TELEPHONE: (650)266-8864
LICENSING EVALUATOR NAME: Haydee R Caliboso	TELEPHONE: (650)266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 01/04/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/04/2022

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: NOAH'S ARK PRESCHOOL	FACILITY NUMBER: 210105564
	VISIT DATE: 01/04/2022

NARRATIVE

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LPA informed the Director and Assistant to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates. Licensee can also email at childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list for the updates.

>No deficiencies were cited today under Title 22 Division 12 of the California Code of Regulations.

This report and rights to comment and appeal were discussed with the Assistant Director. This report must be available in the facility for public review. Notice of site visit shall be posted for 30 days from today's visit. Licensee was advised for any additional questions to call Office, M-F, 8AM-5PM at 650-266-8800. For rules and regulations, visit the website: www.cdss.ca.gov

The report was reviewed and signed by the Assistant Director, Heather Freeman. Today’s report and notice of site visit will be sent to the Assistant Director and Director by the end of the day on 01/04/22. Confirmation of receipt is required.

SUPERVISOR'S NAME: Cindy Interiano	TELEPHONE: (650)266-8864
LICENSING EVALUATOR NAME: Haydee R Caliboso	TELEPHONE: (650)266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 01/04/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/04/2022

LIC809 (FAS) - (06/04)

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