293606323-3-17-2022-03-CC-BMOS-CCLS3Z-20220317133159

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 293606323
Report Date: 03/17/2022
Date Signed: 03/17/2022 01:32:02 PM

Document Has Been Signed on 03/17/2022 01:32 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME:	OUR KIDS' PLACE		FACILITY NUMBER:	293606323
ADMINISTRATOR:	CAROL VIOLA		FACILITY TYPE:	850
ADDRESS:	10846 GILMORE WAY		TELEPHONE:	(530) 274-9106
CITY:	GRASS VALLEY	STATE: CA	ZIP CODE:	95945
CAPACITY:	45	CENSUS:	DATE:	03/17/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	Andi Smith - Program Specialist		TIME COMPLETED:	01:45 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	On Thursday, March 17th, 2022, at 11:36am, Licensing Program Analyst (LPA) Blake Morillas met with the CD Program Specialist, Andi Smith, for the purpose of an unannounced Annual Required inspection. At 11:36am, 29 preschool age children and 4 staff in separate rooms were observed. Operating hours are 8:45am to 3:45pm, Monday through Friday. The facility follows the local school schedule and is closed during the Summer and Holidays. At 11:38am, LPA initiated a health and safety inspection of all indoor and outdoor areas accessible to children. LPA observed that hazardous items (disinfectants, cleaning solutions, etc.) were inaccessible to children in care. Meals are provided by the School District where the program is operating. Snacks are provided by the facility. LPA inspected the food service area and observed that the food products appeared to be protected against contamination. LPA reviewed care and supervision of children, staffing ratios, health related services (including medications and first aid supplies), furniture, equipment, and fire drills logs. LPA observed all required forms to be posted. Sign/in-sign/out sheet were reviewed. Drinking water is readily accessible via drinking fountains to children in care. LPA observed sinks and toilets to be operable. There are adequate toys, equipment, and supplies available for the children. LPA inspected the outdoor play area and observed adequate cushioning material and play equipment to be in safe condition. Shaded areas are also available. *Continued on LIC 809-C

SUPERVISOR'S NAME: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Blake Morillas	TELEPHONE: (916) 208-3734
LICENSING EVALUATOR SIGNATURE:	DATE: 02/18/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/18/2022

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, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: OUR KIDS' PLACE	FACILITY NUMBER: 293606323
	VISIT DATE: 03/17/2022

NARRATIVE

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*Continuation of LIC 809

This facility provides Incidental Medical Services – IMS. 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

At 12:15pm, LPA began to review children’s and staff's files.

The facility representative was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated. All staff currently employed with the facility have criminal record clearances, health screening reports with TB test, immunizations, and Mandated Reporter training. At least one staff member present today has current Pediatric CPR and First Aid.
LPA discussed current Covid-19 guidelines.

LPA provided the Licensing Agency website (ccld.ca.gov), so the Director may obtain updated licensing information, regulations, and forms.
In the areas that were evaluated, there were no deficiencies at this time.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
Exit interview conducted and report was reviewed with the facility representative Andi Smith.

SUPERVISOR'S NAME: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Blake Morillas	TELEPHONE: (916) 208-3734
LICENSING EVALUATOR SIGNATURE:	DATE: 03/17/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2022

LIC809 (FAS) - (06/04)

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