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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 310316182
Report Date: 06/10/2022
Date Signed: 06/10/2022 11:00:55 AM


Document Has Been Signed on 06/10/2022 11:00 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833



FACILITY NAME:LITTLE ORCHARD PRESCHOOLFACILITY NUMBER:
310316182
ADMINISTRATOR:PIETTE, SUSANFACILITY TYPE:
850
ADDRESS:5895 BRACE ROADTELEPHONE:
(916) 652-4973
CITY:LOOMISSTATE: CAZIP CODE:
95650
CAPACITY:43CENSUS: 24DATE:
06/10/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Susan PietteTIME COMPLETED:
11:15 AM
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At approximately 8:15 AM on Friday, June 10, 2022, Licensing Program Analyst (LPA) Amanda Blesi arrived to the facility to conduct a required annual inspection. LPA met with staff Kim Dalman who called and notified director Susie Piette of LPA's arrival. Susan Piette arrived around 9:45 am to assist with the inspection. Operating hours of the facility are from 7:00 a.m.-5:45 p.m., Monday thru Friday. LPA toured the facility at which time a census of 9 preschool children supervised by three staff and a student helper was observed. A second census was conducted at 9 AM and there were 22 children supervised by 4 staff and 1 student helper.

A health and safety inspection were conducted in the classrooms, restrooms, food service areas, and outdoor play areas. LPA observed the following documents are posted: License, Emergency Disaster Plan, Personal Rights, Parents' Rights Poster, menus, and daily schedule. Cleaning disinfectants and hazardous items are appropriately stored and inaccessible to children. Medications are stored, inaccessible to children. Director stated there are no poisons on the premises. Furniture and equipment are in good condition, and toileting facilities are in sanitary, and operating condition. Bins for solid waste in the kitchen have tight fitting lids. The floors appeared clean throughout the facility. Program provides snacks and children bring their own lunch.

There are functional water fountains indoors and outdoors. Children also have labeled water bottles. Playground equipment and surfaces are free of loose or sharp parts. LPA observed wood chip cushioning beneath the play structures. Outdoor shade is provided by trees and awnings. There are no firearms or bodies of water on the premises. LPA observed a functional carbon monoxide detector.

LPA reviewed staff files. At least one staff member present today has current Pediatric CPR and First Aid certification. LPA observed immunization records and documentation of the educational background, training, and/or experience. LPA advised that Mandated Reporter training, AB1207, must be renewed every two years and can be renewed at www.mandatedreporterca.com. (Report continues 809-C)

SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Amanda BlesiTELEPHONE: (916) 208-3427
LICENSING EVALUATOR SIGNATURE:
DATE: 06/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/10/2022
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: LITTLE ORCHARD PRESCHOOL
FACILITY NUMBER: 310316182
VISIT DATE: 06/10/2022
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At 10:00 AM, LPA reviewed children's records. Each child's file contained an emergency card, consent for emergency medical treatment, health history, a record of immunization's and notifications of children’s and parent’s rights.

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.

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 Center Sections 101173 and 101226. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 513-0301 (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.ht


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.

LPA encouraged director to visit the Department website at WWW.CCLD.CA.GOV for child care updates, regulations, current forms, Provider Information Notices (PIN's), and to subscribe to quarterly updates


Exit interview conducted and report was reviewed with the licensee Susan Piette.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.

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
SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Amanda BlesiTELEPHONE: (916) 208-3427
LICENSING EVALUATOR SIGNATURE:

DATE: 06/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2022
LIC809 (FAS) - (06/04)
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