293617518-3-27-2023-03-CC-MGAO-CQBSYQ-20230327141754

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 293617518
Report Date: 03/27/2023
Date Signed: 03/27/2023 02:18:52 PM

COMPREHENSIVE INSPECTION

Document Has Been Signed on 03/27/2023 02:18 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
RIVER CITY (SACTO)CC, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME:	KINDERLAND PRESCHOOL INFANT CENTER		FACILITY NUMBER:	293617518
ADMINISTRATOR:	PETERSON, LUPE		FACILITY TYPE:	830
ADDRESS:	12815 COLFAX HIGHWAY		TELEPHONE:	(530) 273-1255
CITY:	GRASS VALLEY	STATE: CA	ZIP CODE:	95945
CAPACITY:	16	CENSUS: 6	DATE:	03/27/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:55 PM
MET WITH:	Lupe Peterson		TIME COMPLETED:	02:30 PM

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At approximately 12:55pm, Licensing Program Analyst (LPA) Matthew Gallo met with Director Lupe Petersonfor the purpose of an unannounced annual random inspection. Census included 6 infants supervised by 4 staff. Director was reminded never to exceed the conditions, limitations and capacity specified on the license. Facility hours of operation are 7:30am-4:30pm M-Th, and 7:30am to 4:00pm on Friday. Facility does not offer transportation services.

LPAs toured the building including all activity and classroom spaces, restrooms, food service and outdoor play areas. All necessary documents were posted. Director stated there were no poisons, firearms, and LPAs did not observer pools of water on the premises. 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 wood chips. The floors appeared clean throughout the facility. The food preparation space was free of litter and all food was protected against contamination. Storage containers with solid waste had tight-fitting covers. Program does not provide meals, and bottles brought from home were observed to be labeled and in date. 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 as required for infant age component. Medication was properly stored and inaccessible to children.

Sufficient napping equipment was available, and LPA reminded Director 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.

SUPERVISOR'S NAME: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Matthew Gallo	TELEPHONE: (916) 208-3734
LICENSING EVALUATOR SIGNATURE:	DATE: 03/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/27/2023

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: KINDERLAND PRESCHOOL INFANT CENTER	FACILITY NUMBER: 293617518
	VISIT DATE: 03/27/2023

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Staff and children's records were viewed 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. 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.

Director 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.

Exit interview conducted and report was reviewed with the facility representative Lupe Peterson.

No deficiencies were cited during today’s inspection.

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: 03/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/27/2023

LIC809 (FAS) - (06/04)

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