263801648-12-23-2019-12-CC-JSAN-BK5R6D-20191223114434

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 263801648
Report Date: 12/18/2019
Date Signed: 12/23/2019 11:44:49 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550

FACILITY NAME:	IMACA HEAD START/STATE PRESCHOOL-COLEVILLE		FACILITY NUMBER:	263801648
ADMINISTRATOR:	DUNCAN, KATHLEEN		FACILITY TYPE:	850
ADDRESS:	111527 HIGHWAY 395		TELEPHONE:	(530) 495-2137
CITY:	COLEVILLE	STATE: CA	ZIP CODE:	96107
CAPACITY:	16	CENSUS: 14	DATE:	12/18/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	10:03 AM
MET WITH:	Karen Donahue		TIME COMPLETED:	12:34 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) Jacky San met with Site Supervisor, Karen Donahue, today 12/18/2019 for the purpose of conducting an unannounced Annual/Random inspection. LPA toured and inspected all areas according to the facility sketch (1 classrooms). Upon arrival, LPA noted there was 1 teacher, 2 teacher aide and 14 children presents during today inspection. Staff and children files were reviewed as part of this inspection. All staff have current immunization's, fingerprint cleared, associated, and qualified. All staff are certified and have a valid Pediatric CPR and First Aid certificate. Children's files were reviewed and contain all required forms. LPA observed age appropriate furniture, equipment, toys and materials. The classrooms were observed to be clean and safe. Telephone service was verified. Children's belongings are kept in cubbies along the wall as you enter classrooms. Drinking water is available inside the classroom in form of a water bottle. Centers' last Emergency Disaster Drill was conducted 11/06/2019 and 11/21/2019. LPA observed fully charged fire extinguishers last service as of 07/2019, Carbon monoxide detectors and Fire Alarm are in operable and working condition. Classroom contains a first aid kit. The children's bathroom is located inside the classrooms. It contains 1 toilet and 1 sink. The staff rest-room is located in the main office area. LPA observed the bathrooms to be clean and sanitary, with soap, toilet paper and readily available paper towels. Toilets and sinks are functioning properly and age appropriate. **Outdoor play equipment was inspected for health, safety, good repair and age appropriateness. Center utilizes rubber matting -under climbing structures for cushioning material and there is enough and adequate shade available. Center also has sand boxes that has a led, Lead Supervisor states the sand is raked and cleaned daily before children utilize the area. Large play equipment and structures are securely anchored. The area was observed to be free of debris. Outside Drinking water is available; however, is not in used. Center provides "Sippy Cups" which are cleaned daily. There are no bodies of water on the campus.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Jacky San	TELEPHONE: (661) 305-3690
LICENSING EVALUATOR SIGNATURE:	DATE: 12/18/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2019

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, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550

FACILITY NAME: IMACA HEAD START/STATE PRESCHOOL-COLEVILLE	FACILITY NUMBER: 263801648
	VISIT DATE: 12/18/2019

NARRATIVE

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**Food preparation area/Kitchen was inspected for safety, cleanliness, proper equipment & protection against contamination and storage. Storage areas were inspected for inaccessibility of toxins and cleaning compounds to children in care. LPA observed the area to be clean and sanitary. **Water Temperature were observed and tested. LPA tested the hot water temperature at 115 degree. Safe radius fall within 105-120 degree; therefore, is safe for children in care.

· LPA informed Director of the Departments Child Care Advocate’s (CCA’s) that can forward Quarterly updates regarding Child Care Licensing Rules and Regulations. You may contact the Child Care Advocate Program directly: Phone number: (916) 654-1541
Email address: childcareadvocatesprogram@dss.ca.gov

**Parent Board contained all documents that are required to be posted according to Title 22 Regulations. Sign in and out sheets were inspected and contain full legal signatures.

LPA discussed the following:
Senate Bill AB 633 - Child Care Facilities: Parent Notification Requirements
Summary: This bill amends Health and Safety Code (HSC) sections 1596.859, 1596.8595, 1596.8895, and 1597.05 to improve the transparency of licensing records and to ensure that parents/guardians using a licensed child care facility (Center or family child care home) are aware of situations that present the greatest danger to children. These situations include:
· Serious health and safety violations resulting in Type A citations;
· Non-compliance conferences; or
· Efforts by the Department to revoke a facility’s license. Each report (documenting a Type A citation) shall remain posted for 30 days along with the Notice of Site Visit (printed out during this inspection). Failure to meet the posting requirements shall result in an immediate civil penalty. In addition, all parents of currently enrolled children and any newly enrolled child for the following 12 months shall receive a copy of report and sign the LIC 9224 acknowledging receipt. Civil Penalty assessments will be assessed if all above requirements are not adhered to.
Facility Staff was advised to visit www.shotsforschool.org for Immunization information.
Facility Staff was informed of responsibility to report suspected Child Abuse, 1-800-540-4000.
Facility Staff was advised for quarterly updates to contact the Child Care Advocates information: www.childcareadvocatesprogram@cdss.ca.gov

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Jacky San	TELEPHONE: (661) 305-3690
LICENSING EVALUATOR SIGNATURE:	DATE: 12/18/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2019

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, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550

FACILITY NAME: IMACA HEAD START/STATE PRESCHOOL-COLEVILLE	FACILITY NUMBER: 263801648
	VISIT DATE: 12/18/2019

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

§1596.8662. Availability of information regarding detecting and reporting child abuse and neglect; training for mandated reporter who is licensed day care provider, administrator, or employee of a licensed child day care facility; proof of completion

(b) (1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every (2) year following the date on which he or she completed the initial mandated reporter training.

1 deficiencies were cited during this inspection. Exit interview conducted with Site Supervisor, Karen Donahue. A copy of this report, LIC 857, LIC 859, LIC 809-D, Appeal Rights and Notice of Site Visit were discussed and provided to Site Supervisor. Site Supervisor's signature on this form acknowledges receipt of these rights.

Notice of Site Visit has been posted (LIC9213). The notice shall be posted for 30 consecutive days. Failure to maintain posting as required will result in a $100.00 civil penalty. Copies of this report must be posted for 30 days in visible location the authorized representatives of children.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Jacky San	TELEPHONE: (661) 305-3690
LICENSING EVALUATOR SIGNATURE:	DATE: 12/18/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2019

LIC809 (FAS) - (06/04)

Page: 2 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550

FACILITY NAME: IMACA HEAD START/STATE PRESCHOOL-COLEVILLE	FACILITY NUMBER: 263801648
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 12/18/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 12/27/2019 Section Cited	1 2 3 4 5 6 7	(b) (1) Health and Safety Code. On or before March 30, 2018, a person who is a licensed child care provider, administrator, or employee... mandated reporter training every two years following the date on which he/she completed the initial mandated reporter training. This requirement does not met as evidenced by:
	8 9 10 11 12 13 14	Based on observation/interview/record review, the licensee did not ensure to renew mandated reporter; therefore, poses a potential risk to children in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Jacky San	TELEPHONE: (661) 305-3690
LICENSING EVALUATOR SIGNATURE:	DATE: 12/18/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2019

LIC809 (FAS) - (06/04)

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