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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 283009437
Report Date: 06/14/2019
Date Signed: 06/14/2019 02:26:13 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:LITTLE BACKPACKS PRESCHOOL-INFANTFACILITY NUMBER:
283009437
ADMINISTRATOR:KEENER, KATIEFACILITY TYPE:
830
ADDRESS:995 ADAMS STREETTELEPHONE:
(707) 963-4705
CITY:ST. HELENASTATE: CAZIP CODE:
94574
CAPACITY:12CENSUS: 7DATE:
06/14/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Katie Keener, Director/LicenseeTIME COMPLETED:
02:40 PM
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An 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 file indicates that all facility staff have received criminal record and child abuse index clearances or exemptions. This is a combination center with a separate infant and preschool license. Operating hours are 07:30am- 5:30pm, Monday-Friday. They will be closed the last week of July this year.
The facility was toured inside and out with the Director at 1:20pm and the floor and yard plan were verified. The infants are physically separated from the preschool age children in different classrooms. The facility was clean and orderly. The items which could pose a danger to children (detergents, cleaning compounds, and medications) were stored out of reach of the children. Poisons are key locked in an off limits cabinet. The toys, floors and other equipment are clean, safe and age appropriate for infants. There was a crib available for each infant still napping in a crib. The changing table is sanitary and within arm's reach of a sink. A current menu was posted. Food prep areas are clean. Food is properly stored and refrigerated as needed. Garbage cans containing solid waste have tight fitting lids. There is a working carbon monoxide detector and fire extinguisher in the facility. The playground is completely fenced and free of hazards. The infant playground has age appropriate equipment. There is artificial turf cushioning underneath climbing structures and/or play equipment to absorb falls. There were no bodies of water observed. The director stated no firearms are stored on site and none were observed. During today's visit staffing ratios were being met. Two fully qualified staff were supervising seven infants. At least one staff member (S1) present possessed current CPR and First Aid certifications that expires June 2020. Sign in/out procedure was reviewed and in compliance. Five children's records were reviewed at 02:05pm. Children have current Needs and Services Plans in their files. Three staff files were reviewed at 01:40pm and contained transcripts, Mandated Reporter Training certificates and immunizations.
SUPERVISOR'S NAME: Leslie LeporiTELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Kevin O'ConnellTELEPHONE: (707) 588-5026
LICENSING EVALUATOR SIGNATURE:

DATE: 06/14/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 2
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: LITTLE BACKPACKS PRESCHOOL-INFANT
FACILITY NUMBER: 283009437
VISIT DATE: 06/14/2019
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This facility is not providing Incidental Medical Services (IMS) to children. The Department’s IMS policy was discussed with the Director. 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: 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 licensee. The Effects of Lead Exposure brochure has been reviewed with and discussed with the licensee. 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.

There were no Title 22 deficiencies cited during today's inspection.
SUPERVISOR'S NAME: Leslie LeporiTELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Kevin O'ConnellTELEPHONE: (707) 588-5026
LICENSING EVALUATOR SIGNATURE:

DATE: 06/14/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2019
LIC809 (FAS) - (06/04)
Page: 2 of 2