310318620-7-29-2020-03-CC-KOWS-BRYLCW-20200729083859

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 310318620
Report Date: 07/27/2020
Date Signed: 07/29/2020 08:39:15 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:	ADVENTURE CLUB - SPANGER SCHOOL		FACILITY NUMBER:	310318620
ADMINISTRATOR:	BARROW, CAROLYN		FACILITY TYPE:	840
ADDRESS:	699 SHASTA ST RM 1,2,3		TELEPHONE:	(916) 782-7905
CITY:	ROSEVILLE	STATE: CA	ZIP CODE:	95678
CAPACITY:	90	CENSUS: 0	DATE:	07/27/2020
TYPE OF VISIT:	Case Management - Licensee Initiated	ANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Melanie Nett - Recreation Supervisor		TIME COMPLETED:	12:00 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	Licensing Program Analyst (LPA) Katrina Owens is conducting a Case Management tele-inspection with Recreation Supervisor, Melanie Nett for the purpose of requesting to add the multi-purpose room to the school-age license. The inspection is being conducted via Face-time due to COVID-19 pandemic. The license serves 90 school-age children; there is no capacity change with adding the multi-purpose room. The facility will operate traditional school year, August to June; daily from 6:30 am to 6:00 pm. The original fire clearance includes the multi-purpose room. The City of Roseville is allowing the use of the multi-purpose rooms on each elementary school campus in the Roseville City School District for child care purpose. The facility will provide an AM and PM snack. Recreation Supervisor acknowledges that the following documents must be posted at all times: License, Emergency Disaster Plan, Personal Rights, Parents' Rights Poster, car seat law, menus, and daily schedule. INDOOR ACTIVITY SPACE: LPA virtually observed tables and chairs in the multi-purpose room. Staff will bring over the first aid kit with them when multi-purpose room is in use. The multi purpose room has sinks for children hand washing. Medications will be stored in the classroom in a locked box. Water coolers and cups and water bottles will be used in the multi purpose room for drinking water. Children will be signed in/out at the classroom; parents will use their own writing pens to sign child in/out. The facility will also have clean cups/dirty cup for pens used by parent to sign children in and out of facility; pens will be sanitized. The multipurpose room has hand sanitizer available throughout the multipurpose room for children use. Report continues on 809-C

SUPERVISOR'S NAME: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Katrina Owens	TELEPHONE: 916-263-6280
LICENSING EVALUATOR SIGNATURE:	DATE: 07/27/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2020

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: ADVENTURE CLUB - SPANGER SCHOOL	FACILITY NUMBER: 310318620
	VISIT DATE: 07/27/2020

NARRATIVE

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Measurement of multi-purpose room was completed by Recreation Supervisor, Melanie Nett.

The multipurpose room space contains a total of 3706.20 square feet. There are five toilets, one urinals, and four sinks for the children. Individual measurements are recorded on the Capacity Worksheet (LIC 9024). Children who become ill during the day will be isolated in the school office.

OUTDOOR ACTIVITY SPACE:
Refer to the original pre-licensing report for outdoor activity space measurements. There are no changes.

The facility's Plan of Operation is located in the Administrative file. Incidental Medical Services (IMS) policy was discussed.

LPA 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. LPA discussed with Recreation Supervisor 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.

Recreation Supervisor 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.

An exit interview was conducted and in the areas that were evaluated, no deficiencies were observed at the time of the inspection. LPA e-mailed a copy of LIC809 to Program Director. Program Director understands she must read the report and send LPA an e-mail stating she received, read, and understands today’s report.

Pending a final file review, a recommendation will be made to add the multi-purpose room to the school-age license.

SUPERVISOR'S NAME: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Katrina Owens	TELEPHONE: 916-263-6280
LICENSING EVALUATOR SIGNATURE:	DATE: 07/27/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2020

LIC809 (FAS) - (06/04)

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