283000395-10-17-2019-01-CC-KOCL-BH2QBT-20191017120204

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 283000395
Report Date: 10/17/2019
Date Signed: 10/17/2019 12:02:11 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:	HEAD START - MAYACAMAS		FACILITY NUMBER:	283000395
ADMINISTRATOR:	RIOS, ANA		FACILITY TYPE:	850
ADDRESS:	70 CALAVARAS COURT		TELEPHONE:	(707) 253-1303
CITY:	NAPA	STATE: CA	ZIP CODE:	94559
CAPACITY:	20	CENSUS: 20	DATE:	10/17/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Ana Rios, Site Supervisor		TIME COMPLETED:	12:15 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	LPA Kevin O'Connell made an unannounced inspection regarding compliance with Title 22 Regulations. The facility is federally funded and staff are fingerprinted through Department of Education. The facility operates; Monday - Friday; 8:00am - 2:00pm and is open from 8/14/19 through May 22th, 2019. The classroom appeared clean and organized. This center is licensed for 20 children. Present were 4 staff, and 20 children. During today's visit staffing ratios were being met. LPA toured the facility with the Site Director at 10:40 Am on 10/17/19. LPA inspected the classroom and playground. The playground was completely fenced and the equipment appeared in safe condition. There was artificial turf under the climbing structures/ play equipment to absorb falls. Fire extinguishers were charged and at least one carbon monoxide detector was functioning. The items which could pose a danger to children (detergents, cleaning compounds, and medications) were stored out of the reach of children. Disinfectants and cleaning solutions are inaccessible. The toys, floors, desks, and other equipment appeared clean. There is drinking water available to children both indoors and outdoors. The children's bathrooms appeared in safe and sanitary operating condition. Trash cans used for solid waste have tight fitting lids. Kitchen areas appear clean. Breakfast, lunch and snack are served. Menus were posted. Floors and other surfaces appear clean. Furnishings, equipment, toys and activities are age and developmentally appropriate, found in safe condition. The sign in/ out log was in compliance. Nine children's files were checked for admission agreements at 11:00am and were complete.

SUPERVISOR'S NAME: Leslie Lepori	TELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Kevin O'Connell	TELEPHONE: (707) 588-5026
LICENSING EVALUATOR SIGNATURE:	DATE: 10/17/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2019

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 - MAYACAMAS	FACILITY NUMBER: 283000395
	VISIT DATE: 10/17/2019

NARRATIVE

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Four staff files were checked at 11:10am for Mandated Reporter Training certificates & immunizations.
The Site Supervisor states that there are no pools, spas, hot tubs, fish ponds or bodies of water and none were observed.
The Site Supervisor states that there are no guns or dangerous weapons and none were observed. At least one teacher who opens and closes had current Pediatric First Aid and CPR certifications.
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 Site Supervisor. The Effects of Lead Exposure brochure has been reviewed with and discussed with the 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: 10/17/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2019

LIC809 (FAS) - (06/04)

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