293623581-6-2-2020-03-CC-SDLA-BQ7UEX-20200602153151

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 293623581
Report Date: 05/28/2020
Date Signed: 06/02/2020 03:32:02 PM

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:	LITTLE GEMS		FACILITY NUMBER:	293623581
ADMINISTRATOR:	SIMON, JAIME		FACILITY TYPE:	850
ADDRESS:	908 NORTHSTAR DRIVE		TELEPHONE:	(530) 448-4522
CITY:	TRUCKEE	STATE: CA	ZIP CODE:	96161
CAPACITY:	30	CENSUS: 0	DATE:	05/28/2020
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Jaime Simon		TIME COMPLETED:	03:30 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	Application Specialist (AS) Seychelle De Luca met with Applicant Jaime Simon for the purpose of an announced prelicensing change of location tele-inspection (due to COVID-19). Applicant requests a preschool license to serve 20 preschool children from age two to entry into kindergarten and 10 toddler children from 18 months to 36 months under a Toddler Option Program. The program will operate Monday through Sunday from 8:00 AM to 5:00 PM. The fire clearance was granted on 5/28/2020. Applicant acknowledges that the following documents must be posted at all times: License, Emergency Disaster Plan, Personal Rights, Parents' Rights Poster, menus, and daily schedule. AS discussed the forms that must be in each child's and each staff member's file. The facility will be providing breakfast, lunch, and afternoon snack. INDOOR ACTIVITY SPACE: There are five classrooms: Preschool Classrooms 1, 2, and 3, and Toddler Classrooms 1 and 2. The preschool classrooms are located on the level one and toddler classrooms are located on level two. AS observed a sufficient amount of equipment, toys, tables, chairs, and cubbies to meet the requested capacity. There are several first aid kits in the facility. Medications will be stored in the office. AS observed cleaning disinfectants are appropriately stored and inaccessible to children. Applicant stated there are no poisons or firearms on the premises. Applicant stated children will bring water bottles. AS observed a functional carbon monoxide detector that is built into the fire alarm system. AS observed a paper sign-in/sign-out system. Report continues on 809-C.

SUPERVISOR'S NAME: Roxana Saravia	TELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Seychelle De Luca	TELEPHONE: (916) 217-4316
LICENSING EVALUATOR SIGNATURE:	DATE: 05/28/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/28/2020

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: LITTLE GEMS	FACILITY NUMBER: 293623581
	VISIT DATE: 05/28/2020

NARRATIVE

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Applicant measured the five classrooms, and AS walked Applicant through the measuring process. The total classroom space contains a total of 1715.695 square feet, which will accommodate Applicant's request for 30 children. There are three toilets and three sinks for the children, and a separate private restroom for the staff. Individual measurements are recorded on the Capacity Worksheet (LIC 9024). Children who become ill during the day will be isolated in the office area and will use the staff restroom, if necessary.

OUTDOOR ACTIVITY SPACE:
There is one outdoor area on the property. The outdoor play area is fenced with a fence that is at least four feet tall. AS observed a sufficient amount of equipment and toys. Applicant stated the monkey bars and climbing equipment are anchored into the ground. There are no bodies of water on the premises. There are shaded areas supplied by trees. Prior to today's tele-inspection, Applicant submitted a waiver request for preschoolers and toddlers to share the outdoor space.

Applicant measured the outdoor activity space, and AS walked Applicant through the measuring process. The outdoor play area contains a total of 2098.787 square feet, which will not accommodate Applicant's request for 30 children. Individual measurements are recorded on the Capacity Worksheet (LIC 9024).

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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.

Report continues on 809-C.

SUPERVISOR'S NAME: Roxana Saravia	TELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Seychelle De Luca	TELEPHONE: (916) 217-4316
LICENSING EVALUATOR SIGNATURE:	DATE: 05/28/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/28/2020

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: LITTLE GEMS	FACILITY NUMBER: 293623581
	VISIT DATE: 05/28/2020

NARRATIVE

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AS discussed the following: 100% supervision is required at all times, including in the bathroom; personal rights; inspection authority; reporting requirements; staff to children ratios and capacity; staff qualifications; and maintaining buildings and grounds. AS discussed with Applicant 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.

This facility evaluation report was reviewed and discussed with Applicant. Applicant was encouraged to the visit the Department's website at WWW.CDSS.CA.GOV for information regarding child care updates, forms, regulations and legislation pertaining to child care centers.

AS emailed a copy of the 809 to Applicant. Applicant understands she must open the email to send back an acknowledgement of receipt. AS also emailed LIC311A, Effects of Lead Exposure brochure, Healthy Schools Act survey, and immunization card.

THE FOLLOWING ITEMS MUST BE SENT IN PRIOR TO ISSUING A PROVISIONAL LICENSE:

1. A second walk through to verify Preschool classrooms 2 and 3 have been cleared out and set up. 2. Proof 10 more napping cots have been ordered. 3. Submit an updated waiver request which states no more than 27 children may use the outdoor space at one time.

SUPERVISOR'S NAME: Roxana Saravia	TELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Seychelle De Luca	TELEPHONE: (916) 217-4316
LICENSING EVALUATOR SIGNATURE:	DATE: 05/28/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/28/2020

LIC809 (FAS) - (06/04)

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