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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 280100572
Report Date: 01/06/2020
Date Signed: 01/06/2020 11:58:32 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA
FACILITY NAME:NOAH'S ARK CHRISTIAN SCHOOL AND DAY CAREFACILITY NUMBER:
280100572
ADMINISTRATOR:BOHLEN, CHRISTINAFACILITY TYPE:
850
ADDRESS:2 ANDREW ROADTELEPHONE:
(707) 644-6465
CITY:AMERICAN CANYONSTATE: CAZIP CODE:
94503
CAPACITY:80CENSUS: 28DATE:
01/06/2020
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
10:35 AM
MET WITH:Christina BohlenTIME COMPLETED:
12:13 PM
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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 01/06/20 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; 6:30 am to 6:00 pm in five classrooms. The facility was toured with the Director at 10:43am and the floor and yard plan submitted by the licensee were verified. This facility is licensed for 80 children. 6 teachers were supervising 28 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. Poisons are key locked in the outside shed/closet. 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 in each classroom.
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. All teachers had current Pediatric CPR and First Aid certifications on file.
SUPERVISOR'S NAME: Leslie LeporiTELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Kevin O'ConnellTELEPHONE: (707) 588-5026
LICENSING EVALUATOR SIGNATURE:

DATE: 01/06/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2020
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,
, CA
FACILITY NAME: NOAH'S ARK CHRISTIAN SCHOOL AND DAY CARE
FACILITY NUMBER: 280100572
VISIT DATE: 01/06/2020
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The electronic sign-in/sign-out procedure was reviewed and in compliance. Six staff records were reviewed at 11:30am for immunizations, Mandated Reporter Certificates and education transcripts and all were complete. Ten children’s records were reviewed at 11:20am, 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 LeporiTELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Kevin O'ConnellTELEPHONE: (707) 588-5026
LICENSING EVALUATOR SIGNATURE:

DATE: 01/06/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2020
LIC809 (FAS) - (06/04)
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