280107123-5-8-2019-01-CC-KOCL-BBYS7R-20190508133758

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 280107123
Report Date: 05/08/2019
Date Signed: 05/08/2019 01:38:04 PM

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:	ST. HELENA COOPERATIVE NURSERY SCHOOL		FACILITY NUMBER:	280107123
ADMINISTRATOR:	KELLY, MAUREEN		FACILITY TYPE:	850
ADDRESS:	HWY. 29 AND NIEBAUM LANE		TELEPHONE:	(707) 963-7212
CITY:	RUTHERFORD	STATE: CA	ZIP CODE:	94573
CAPACITY:	30	CENSUS: 16	DATE:	05/08/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	11:50 AM
MET WITH:	Maureen Kelly		TIME COMPLETED:	01:50 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. A review of the Facility Personnel Report Summary indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances. This preschool is licensed for 30 children. Two teachers and three parents were directly supervising 16 preschool children. During today's inspection, staffing ratios and capacity were being met. The facility operates Monday -Friday from 9am -12pm, Monday & Wednesday 1pm- 4pm, Tuesdays 12:30 to 3:30pm and Thursdays 3:30 - 5:30. There is no napping. The facility was toured inside and outside with the Director at 11:55 am and the floor and yard plan submitted by the licensee were verified. The items which could pose a danger to children (such as detergents, cleaning compounds and medications) were observed to be inaccessible to children. There are currently no poisons on the premises. 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. Children bring lunches and snacks are provided. A menu was posted. Garbage containers containing solid waste have tight fitting lids. The LPA observed a working carbon monoxide detector and a charged fire extinguisher of at least 2A 10: BC or larger present in the room. The playground was free of hazards. The playground equipment and surface areas were in safe condition. There is pea gravel for cushioning underneath climbing structures and/or play equipment to absorb falls. The Director stated that there were no bodies of water and none were observed. The Director also stated that no weapons are stored on site and none were observed.

SUPERVISOR'S NAME: Leslie Lepori	TELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Kevin O'Connell	TELEPHONE: (707) 588-5026
LICENSING EVALUATOR SIGNATURE:	DATE: 05/08/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2019

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,
, CA

FACILITY NAME: ST. HELENA COOPERATIVE NURSERY SCHOOL	FACILITY NUMBER: 280107123
	VISIT DATE: 05/08/2019

NARRATIVE

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Three staff records were reviewed at 12:45pm. Staff had current Mandated Reporter Certificates, Immunizations, documentation of education and First Aid & CPR certifications.
The sign-in/sign-out procedure was reviewed and in compliance. Ten children’s records were reviewed at 12:20 pm, and contained signed admission agreements.
Incidental Medical Services (IMS) policy was discussed. This facility is administering IMS at this time (2 epi-pens).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. 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

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. Licensee's Rights were given 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) 588-5026
LICENSING EVALUATOR SIGNATURE:	DATE: 05/08/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2019

LIC809 (FAS) - (06/04)

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