313609613-3-29-2022-03-CC-BMOS-CCYSPM-20220329140322

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 313609613
Report Date: 03/29/2022
Date Signed: 03/29/2022 02:03:48 PM

Document Has Been Signed on 03/29/2022 02:03 PM - 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:	A+ PROGRAM - PRESCHOOL		FACILITY NUMBER:	313609613
ADMINISTRATOR:	HALEY GRIFFIN		FACILITY TYPE:	850
ADDRESS:	390 FAIRWAY DRIVE		TELEPHONE:	(530) 583-1534
CITY:	TAHOE CITY	STATE: CA	ZIP CODE:	96145
CAPACITY:	36	CENSUS:	DATE:	03/29/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:20 AM
MET WITH:	Jenn Capshaw - Administrator		TIME COMPLETED:	02:30 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	On Tuesday, March 29th, 2022, at 10:26am, Licensing Program Analyst (LPA) Blake Morillas met with the Administrator, Jenn Capshaw, for the purpose of an unannounced Annual Required inspection. At 10:33am, 13 preschool age children and 2 staff outside were observed. There were no children inside the building at the time of arrival. Operating hours are 8:00am to 5:00pm, Monday through Friday. The facility operates year around. At 10:42am, LPA initiated a health and safety inspection of all indoor and outdoor areas accessible to the children in care. LPA observed that hazardous items (disinfectants, cleaning solutions, etc.) were inaccessible to children in care. Due to previous Covid-19 guidelines, the Facility has discontinued providing meals and snacks to the children in care. Parents now supply all snacks and meals for their children with the exception if food is forgotten then the facility may provide a snack. The Administrator noted that they are unsure if their meal program will be re-implemented. LPA reviewed care and supervision of children, staffing ratios, health related services (including medications and first aid supplies), furniture, equipment, and fire drills logs. LPA observed all required forms to be posted. Digital Sign/in-sign/out reports were reviewed. LPA observed sinks and toilets to be operable. There are adequate toys, equipment, and supplies available for the children. The outdoor play area was observed to have adequate cushioning material and play equipment to be in safe condition. Shaded areas are also available. Continued on LIC 809-C Page 1 of 3*

SUPERVISOR'S NAME: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Blake Morillas	TELEPHONE: (916) 208-3734
LICENSING EVALUATOR SIGNATURE:	DATE: 03/29/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2022

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 4

Document Has Been Signed on 03/29/2022 02:03 PM - It Cannot Be Edited

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: A+ PROGRAM - PRESCHOOL	FACILITY NUMBER: 313609613
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/29/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

CCR

101170(d)

Criminal Record Clearance

(d) All individuals subject to criminal record review shall, be fingerprinted and sign a Criminal Record Statement (LIC 508 [Rev. 1/03]) under penalty of perjury. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observations and during the staff record review, the Administrator did not comply with the section cited above in one out of the two teachers present, which poses an immediate health, safety or personal rights risk to persons in care.
	POC Due Date: 03/29/2022
	Plan of Correction
1 2 3 4	Upon the discovery that S1 had not been fingerprinted, the Administrator immediately took action and removed the individual from the program and sent them to get Livescaned. The Administrator was reminded that S1 can not return until they have received their background clearance. Civil Penalty Issued. Citation cleared during visit due to S1 providing receipt of Livescan services.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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: Blake Morillas	TELEPHONE: (916) 208-3734
LICENSING EVALUATOR SIGNATURE:	DATE: 03/29/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2022

LIC809 (FAS) - (06/04)

Page: 2 of 4

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: A+ PROGRAM - PRESCHOOL	FACILITY NUMBER: 313609613
	VISIT DATE: 03/29/2022

NARRATIVE

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*Continuation of LIC 809

Due to previous Covid-19 guidelines, Drinking Fountains inside and outside of the facility have been disabled. Drinking water is readily accessible and currently provided to children in care by the use of water bottles.

At 11:19am, LPA began to review children’s and staff's files. All staff currently employed with the facility have health screening reports with TB test, immunizations, and Mandated Reporter training. At least one staff member present today has current Pediatric CPR and First Aid.

The Administrator 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.

LPA discussed current Covid-19 guidelines as well as the water lead testing process.

LPA provided the Licensing Agency website (ccld.ca.gov), so the Administrator may obtain updated licensing information, regulations, and forms.

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 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

Continued on LIC 809-C Page 2 of 3

SUPERVISOR'S NAME: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Blake Morillas	TELEPHONE: (916) 208-3734
LICENSING EVALUATOR SIGNATURE:	DATE: 03/29/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2022

LIC809 (FAS) - (06/04)

Page: 3 of 4

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: A+ PROGRAM - PRESCHOOL	FACILITY NUMBER: 313609613
	VISIT DATE: 03/29/2022

NARRATIVE

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Continuation of LIC 809-C

LPA Blake Morillas informed Administrator, Jenn Capshaw, that this report dated 3-29-2022 document(s) one Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPA Blake Morillas informed the Administrator to provide a copy of this licensing report dated 3-29-2022 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

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.

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.

Exit interview conducted and report was reviewed with the Administrator, Jenn Capshaw.

Page 3 of 3

SUPERVISOR'S NAME: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Blake Morillas	TELEPHONE: (916) 208-3734
LICENSING EVALUATOR SIGNATURE:	DATE: 03/29/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2022

LIC809 (FAS) - (06/04)

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