293616013-5-18-2023-03-CC-MGAO-CRXP6H-20230518110221

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 293616013
Report Date: 05/18/2023
Date Signed: 05/18/2023 11:02:37 AM

Document Has Been Signed on 05/18/2023 11:02 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVER CITY (SACTO)CC, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME:	KIDZCOMMUNITY - GRASS VALLEY HEAD START (INF)		FACILITY NUMBER:	293616013
ADMINISTRATOR:	CRECIA (MORGAN) BILDERBACK		FACILITY TYPE:	830
ADDRESS:	130 PARK AVENUE		TELEPHONE:	(530) 272-2635
CITY:	GRASS VALLEY	STATE: CA	ZIP CODE:	95945
CAPACITY:	16	CENSUS: 7	DATE:	05/18/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Julie Hessom		TIME COMPLETED:	11:10 AM

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At approximately 9:30am, Licensing Program Analyst (LPA) Matthew Gallo met with facility representative Julie Hessom for the purpose of an unannounced annual random inspection. Census included 7 toddlers supervised by 4 staff. The infant component is closed today due to a staff shortage. Facility representative was reminded never to exceed the conditions, limitations and capacity specified on the license. Facility hours of operation are 8:30am-3pm. Facility does not offer transportation services.

LPA toured the building including all activity and classroom spaces, restrooms, food service and outdoor play areas. All necessary postings were observed. Director stated there were no poisons or firearms on the premises, and LPA did not observe any bodies of water. All toxic and hazardous items were inaccessible to children. Functional carbon monoxide detector and smoke detector were present. Furniture and equipment were in good condition, and LPA communicated the importance of regularly checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/, further recommending they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment. Playground equipment and surfaces were free of loose or sharp parts, and the areas underneath or around climbing equipment were sufficiently cushioned with rubber padding. The floors appeared clean throughout the facility. Program provides breakfast, lunch, and snack and menus were posted in visible sight. The food preparation space was free of litter and all food was protected against contamination. Storage containers with solid waste had tight-fitting covers. Drinking water was readily available to children both indoors and outdoors. LPA observed full legal signatures while reviewing the sign in and sign out sheet. Medication was properly stored and inaccessible to children.

Sufficient napping equipment was available, and LPA reminded facility representative that napping infants must have 100% visual supervision at all time. LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. Report Continues on 809-C

SUPERVISOR'S NAME: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Matthew Gallo	TELEPHONE: (916) 208-3734
LICENSING EVALUATOR SIGNATURE:	DATE: 05/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2023

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
RIVER CITY (SACTO)CC, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: KIDZCOMMUNITY - GRASS VALLEY HEAD START (INF)	FACILITY NUMBER: 293616013
	VISIT DATE: 05/18/2023

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Staff and children's records were reviewed and observed to be complete. Review of staff records confirmed at least one staff member present today has current Pediatric CPR and First Aid certification, and that all staff currently employed with the facility have valid AB1207 Manded Reporter Training certificates. Criminal record clearances were also verified, and 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. LPA reviewed the Department's inspection authority and discussed with designee any changes that may occur regarding the director or an employee acting in the director's absence must be reported to department within 10 working days.

LPA discussed Assembly Bill 2370, which will require licensed Child Care facilities to test their water for excessive amounts of lead. Testing will be required beginning January 1st, 2020 to January 1st, 2023 and must be conducted every five years from initial testing.

Facility representative was encouraged to the visit the departments website at WWW.CCLD.CA.GOV for information regarding childcare updates, forms, regulations and legislation pertaining child care centers.

No deficiencies were cited during today’s inspection.

Exit interview conducted and report was reviewed with the facility representative Julie Hessom. Appeal rights and a Notice of Site Visit were provided, the latter of which must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISOR'S NAME: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Matthew Gallo	TELEPHONE: (916) 208-3734
LICENSING EVALUATOR SIGNATURE:	DATE: 05/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2023

LIC809 (FAS) - (06/04)

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