313606939-10-28-2020-03-CC-SDLA-BUTPE3-20201028111427

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 313606939
Report Date: 10/27/2020
Date Signed: 10/28/2020 11:14:40 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:	SIERRA COLLEGE AUBURN STATE PRESCHOOL		FACILITY NUMBER:	313606939
ADMINISTRATOR:	JO ANN STOTESBERRY		FACILITY TYPE:	850
ADDRESS:	3050 BELL RD. RM 30		TELEPHONE:	(530) 823-0380
CITY:	AUBURN	STATE: CA	ZIP CODE:	95603
CAPACITY:	48	CENSUS: 0	DATE:	10/27/2020
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Teresa Dawson-Roberts		TIME COMPLETED:	10:00 AM

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 Manager Teresa Dawson-Roberts for the purpose of an announced case management tele-inspection (due to COVID-19). Manager requests to increase the capacity from 48 to 72 and add classroom 31. Currently, the program operates in classrooms K1 and 30. The program will operate Monday through Friday from 8:00 AM to 11:00 AM and 12:30 PM to 3:30 PM in classrooms 30 and 31. The program will operate Monday through Friday from 8:00 AM to 2:30 PM in K1. AS received the fire clearance on 10/21/2020. INDOOR ACTIVITY SPACE: AS observed the following documents and forms are posted: License, Emergency Disaster Plan, Personal Rights, Parents' Rights Poster, car seat poster, menus, and daily schedule. The facility will provide morning and afternoon snacks for part-day programs and breakfast, lunch, and afternoon snack for full-day program. AS observed a sufficient amount of equipment, toys, tables, chairs, napping cots, and cubbies for the requested capacity. AS observed a a first aid kit and medication box. Cleaning disinfectants are appropriately stored and inaccessible to children. Manager stated there are no poisons or firearms on the premises. Manager stated a water jug and cups will be used during COVID-19. AS observed a functional carbon monoxide detector. Manager stated that a paper sign-in/sign-out system. Manager measured classroom: 31; and AS walked her through the measuring process. AS used measurements of 30 and K1 from previous inspections. The total classroom space contains a total of 2925.8 square feet, which accommodates the request for 72 preschool children. There are six toilets and six 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. 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: 10/27/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2020

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: SIERRA COLLEGE AUBURN STATE PRESCHOOL	FACILITY NUMBER: 313606939
	VISIT DATE: 10/27/2020

NARRATIVE

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OUTDOOR ACTIVITY SPACE:
There is one outdoor area on the property. The outdoor play area is fenced with a chain link fence that is at least four feet tall. AS observed a sufficient amount of equipment and toys. There are no bodies of water on the premises. There are shaded areas supplied by overhangs. AS used measurements of the outdoor space from previous inspections. The outdoor play area contains a total of 12,180 square feet, which will accommodate the request for 72 preschool children. Individual measurements are recorded on the Capacity Worksheet (LIC 9024).

Incidental Medical Services and a Plan of Operation is located in the Administrative file. 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.

AS discussed the following: supervision; personal rights; inspection authority; reporting requirements; staff to children ratios and capacity; staff qualifications; and maintaining buildings and grounds. AS discussed with Manager 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 Manager. Manager 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 LIC 809 and a Notice of Site Visit to Manager. Manager understands she must read the report and send AS an email stating she received, read, and understands today’s report.

AS will approve the request to add room 31 and increase the capacity to 72 preschool children once the following items are received: 1. Updated Application (LIC 200A) 2. Director's Packet.

SUPERVISOR'S NAME: Roxana Saravia	TELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Seychelle De Luca	TELEPHONE: (916) 217-4316
LICENSING EVALUATOR SIGNATURE:	DATE: 10/27/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2020

LIC809 (FAS) - (06/04)

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