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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 293615974
Report Date: 10/22/2019
Date Signed: 10/22/2019 11:58:29 AM

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:TRUCKEE STATE PRESCHOOLFACILITY NUMBER:
293615974
ADMINISTRATOR:HOLT, BOBBEFACILITY TYPE:
850
ADDRESS:11911 DONNER PASS ROADTELEPHONE:
(530) 582-2500
CITY:TRUCKEESTATE: CAZIP CODE:
96161
CAPACITY:24CENSUS: 18DATE:
10/22/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Bobbe Holt - DirectorTIME COMPLETED:
12:15 PM
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Licensing Program Analyst (LPA) Blake Morillas met with the Director, Bobbe Holt, for the purpose of an unannounced Annual/Random inspection. Today’s census was 18 preschool age children and 3 staff.

Operating hours are 8:00am to 11:30am and 12:00pm to 3:15pm, Monday through Friday. The facility follows the local school calendar.

LPA observed that hazardous items (disinfectants, cleaning solutions etc.) were inaccessible to children in care.

LPA reviewed care and supervision of children, staffing ratios, health related services (including medications and first aid supplies), furniture, equipment, and fire drills logs. Drinking water is readily accessible to children in care in the classroom and outside in the play area.

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 equipment to be in safe condition, with adequate cushioning material. Shaded areas are also available.

LPA observed all required forms to be posted. First aid supplies were also available.

LPA reviewed the sign/in-sign/out sheet and reviewed children’s and staff's files. Some staff files are housed off site and were inspected at the off site location.

*Continued on LIC 809-C
SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Blake MorillasTELEPHONE: (916) 208-3734
LICENSING EVALUATOR SIGNATURE:

DATE: 10/22/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2019
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, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME: TRUCKEE STATE PRESCHOOL
FACILITY NUMBER: 293615974
VISIT DATE: 10/22/2019
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*Continuation of LIC 809

All staff currently employed with the facility have criminal record clearances, health screening reports with TB test, and Mandated Reporter training. At least one staff member present today has current Pediatric CPR and First Aid.

LPA provided and discussed the Safe Sleep in Child Care and Lead Testing brochures (AB 2370).

LPA provided the Licensing Agency website (www.ccld.ca.gov), so the Director may obtain updated licensing information, regulations, and forms.



Incidental Medical Services (IMS) policy was discussed. 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

In the areas that were evaluated, no deficiencies were cited during the visit.



Report was reviewed with the Director and an exit interview was conducted.

Notice of Site Visit posted.
SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Blake MorillasTELEPHONE: (916) 208-3734
LICENSING EVALUATOR SIGNATURE:

DATE: 10/22/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2019
LIC809 (FAS) - (06/04)
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