313605651-7-11-2019-03-CC-ABLI-BDYQB4-20190711120055

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 313605651
Report Date: 07/11/2019
Date Signed: 07/11/2019 12:01:06 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:	KIDZKOUNT CHILD DEVELOPMENT CENTER, LOOMIS		FACILITY NUMBER:	313605651
ADMINISTRATOR:	GREEN, STACEY		FACILITY TYPE:	830
ADDRESS:	5400 BARTON ROAD		TELEPHONE:	(916) 652-3284
CITY:	LOOMIS	STATE: CA	ZIP CODE:	95650
CAPACITY:	35	CENSUS: 11	DATE:	07/11/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	10:45 AM
MET WITH:	Lindsey Shaffer		TIME COMPLETED:	12:15 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	An unannounced annual random inspection for the infant program is conducted today by Licensing Program Analyst Amanda Blesi. LPA met with Early Head Start Coach Lindsey Shaffer. LPA was informed that director was on vacation. A tour of the infant area was conducted. LPA observed 11 infants being cared for by five staff. The infant indoor and outdoor activity space is physically separate from the space used by other day care children. Infant furniture and equipment, including cots/mats, and feeding chairs are sufficient, age appropriate and in good repair. Infant changing tables have padded surface no less than one inch thick, covered with washable vinyl or plastic, and have raised sides at least three inches high. Toys are safe, without sharp points, edges, splinters or small parts that can be pulled off and swallowed. Facility is in compliance with staff infant ratios. All infants, including those napping in cribs, are under visual observation at all times. Feeding plans reviewed for some infants. Needs and Services plans reviewed for some infants. Staff utilized as infant teachers have three child development units in infant/toddler care. There are no bodies of water on the premises. Firearms and ammunition are not on the premises. Storage area for poisons is locked. Disinfectants, hazardous items and medications are inaccessible to children. LPA observed a working carbon monoxide detector. Fire drills are conducted every month and documented. Floors were observed to be clean. The facility is in compliance with conditions and limitations specified on the license. All staff subject to a criminal record clearance or exemption are associated to the facility. First Aid/CPR reviewed and in compliance. Emergency information reviewed for some children. Staff records reviewed contain documentation of the educational background, training, and/or experience and, a Health Screening/TB test and immunization records to meet SB 792. To order forms visit our website at www.ccld.ca.gov

SUPERVISOR'S NAME: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Amanda Blesi	TELEPHONE: (916) 208-3427
LICENSING EVALUATOR SIGNATURE:	DATE: 07/11/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2019

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: KIDZKOUNT CHILD DEVELOPMENT CENTER, LOOMIS	FACILITY NUMBER: 313605651
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/11/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Deficiency Dismissed Type A 07/12/2019 Section Cited	1 2 3 4 5 6 7	To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs. LPA observed two children sleeping in a cribs which have been recalled since 2012 due to the drop down sides.
	1 2 3 4 5 6 7
	1 2 3 4 5 6 7
	1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Amanda Blesi	TELEPHONE: (916) 208-3427
LICENSING EVALUATOR SIGNATURE:	DATE: 07/11/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2019

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: KIDZKOUNT CHILD DEVELOPMENT CENTER, LOOMIS	FACILITY NUMBER: 313605651
	VISIT DATE: 07/11/2019

NARRATIVE

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Mandated Reporter Training
LPA advised the Director on the new regulation AB 1207- California Child Care Worker: Mandated Reporter Training. The licensee and staff must complete the training every two years starting January 1, 2018 and retain proof of completion in the facility file. The training can be could at: mandatedreporterca.com. LPA observed staff files contain proof of the training.

IMS
This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication (no medication onsite today) and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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

LPA informed Ms. Shaffer of the provider meeting which will be held on September 4, 2019 at the Placer County Office of Education in Rocklin.
Per California Code of Regulations, Title 22, Division 12, Chapter 1, deficiencies are noted on the following report. See LIC 809-D. Appeal rights provided.

Licensing report was reviewed and discussed with facility representative. Appeal Rights Provided.

This is a Type A deficiency, hence AB633 Notification Applies: Upon receipt of this report, the report must be posted along with the notice of site visit for 30 days for parents to view. Licensee must inform the parents/guardians of children in care at the facility and to the parents/guardians of children newly enrolled at the facility during the next 12 months via form LIC 9224 Acknowledgement of Receipt of Licensing Reports

SUPERVISOR'S NAME: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Amanda Blesi	TELEPHONE: (916) 208-3427
LICENSING EVALUATOR SIGNATURE:	DATE: 07/11/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2019

LIC809 (FAS) - (06/04)

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