280111518-6-19-2019-01-CC-KOCL-BDANDE-20190619102213

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 280111518
Report Date: 06/19/2019
Date Signed: 06/19/2019 10:22:19 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:	HEAD START - MENLO CENTER		FACILITY NUMBER:	280111518
ADMINISTRATOR:	KIMBERLY ROBINSON		FACILITY TYPE:	850
ADDRESS:	1551 MYRTLE AVENUE		TELEPHONE:	(707) 224-8955
CITY:	NAPA	STATE: CA	ZIP CODE:	94558
CAPACITY:	68	CENSUS: 26	DATE:	06/19/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Socorro Fernandez, Assistant Site Supervisor		TIME COMPLETED:	10:35 AM

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. This is a Title 5 Program. A review of the personnel report on file indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. The facility operates Monday, Tuesday, Thursday, Friday, 7:30am- 04:30pm and Wednesdays 7:30am- 3:00pm. Breakfast, lunch snack are provided. Menus were posted. This center is licensed for 68 children. Present were 26 children and 7 staff. Today care was being provided in 2 classrooms (1 & 4). The facility was operating within the licensed capacity and staffing ratios were being met. The facility was toured inside and outside with the Assistant Site Supervisor at 09:00 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. The Assistant Site Supervisor states that there are no poisons but knows to key or combination lock them if any are accumulated. 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. 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. The playground was free of hazards. The playground equipment and surface areas were in safe condition. There is artificial turf/ carpet material & Pour & Play for cushioning underneath climbing structures and/or play equipment to absorb falls. The Assistant Site Supervisor states that there are no bodies of water and none were observed. The Assistant Site Supervisor stated 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: 06/19/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2019

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: HEAD START - MENLO CENTER	FACILITY NUMBER: 280111518
	VISIT DATE: 06/19/2019

NARRATIVE

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Pediatric First Aid and CPR certifications were reviewed and were current. Five staff records were reviewed at 09:30am and contained immunizations and valid Mandated Reporter Certificates.
The sign-in/sign-out procedure was reviewed and in compliance. Ten children’s records were reviewed at 09:15am, and contained signed admission agreements.
Incidental Medical Services (IMS) policy was discussed. This facility provides Incidental Medical Services – IMS (inhalers). 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 Assistant Site Supervisor. The Effects of Lead Exposure brochure has been reviewed with and discussed with the Assistant Site Supervisor. All licensing reports are public information and must be made available upon request for at least three years.

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

Failure to keep this notice posted for 30 days may result in a civil penalty of $100.
No deficiencies were cited today.

SUPERVISOR'S NAME: Leslie Lepori	TELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Kevin O'Connell	TELEPHONE: (707) 588-5026
LICENSING EVALUATOR SIGNATURE:	DATE: 06/19/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2019

LIC809 (FAS) - (06/04)

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