313609912-5-3-2022-03-CC-ABLI-CE3RMK-20220503130853

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 313609912
Report Date: 05/03/2022
Date Signed: 05/03/2022 01:08:59 PM

Document Has Been Signed on 05/03/2022 01:08 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:	LITTLE SCHOOL HOUSE, THE		FACILITY NUMBER:	313609912
ADMINISTRATOR:	MEACHIM, MISTY		FACILITY TYPE:	850
ADDRESS:	801 EAST AVE.		TELEPHONE:	(916) 434-1942
CITY:	LINCOLN	STATE: CA	ZIP CODE:	95648
CAPACITY: 45	TOTAL ENROLLED CHILDREN: 45	CENSUS: 40	DATE:	05/03/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Misty Meachim		TIME COMPLETED:	01:30 PM

NARRATIVE

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All times on this report are approximations. At 9:45 a.m. on Tuesday, May, 3, 2022, Licensing Program Analyst (LPA) Amanda Blesi met with Director, Misty Meachim, for the purpose of an unannounced 1 year required inspection.. LPA toured the facility, at which time a census of 40 preschool children supervised by five staff was observed.

A health and safety inspection was conducted. Facility has one large open classroom and two smaller classrooms in the rear of the building. Restrooms, food service areas, and outdoor play areas were inspected. 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. Poisons are locked in outdoor shed. 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.

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 structure. 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 reviewed AB 1207 Mandated Reporter training certificates. Director was advised that Mandated Reporter training must be renewed every two years and can be renewed at www.mandatedreporterca.com. (Report continues on 809-C)

SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Amanda Blesi
LICENSING EVALUATOR SIGNATURE:	DATE: 05/03/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2022

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 SCHOOL HOUSE, THE	FACILITY NUMBER: 313609912
	VISIT DATE: 05/03/2022

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At 12 p.m., LPA reviewed children's records.

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. LPA observed Staff #1 fingerprint clearance was not transferred prior to employment in 2020.

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.

Title 22 Deficiency has been cited on the attached LIC 809-D. LPA Amanda Blesi informed facility representative, Misty Meachim that this report dated 5/3/22 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 Amanda Blesi informed the facility representative to provide a copy of this licensing report dated 5/3/22 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. Appeal Rights given.

Exit interview conducted and report was reviewed with the facility representative Misty Meachim. 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

SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Amanda Blesi
LICENSING EVALUATOR SIGNATURE:	DATE: 05/03/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 05/03/2022 01:08 PM - It Cannot Be Edited

Created By: Amanda Blesi On 05/03/2022 at 12:40 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: LITTLE SCHOOL HOUSE, THE	FACILITY NUMBER: 313609912
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/03/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

CCR

101170(e)(2)

Criminal Record Clearance

(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility: (2) Request a transfer of a criminal record clearance as specified in Section 101170(f) or This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in staff #1 had a criminal record clearance and was not associated to the facility. The employee has worked at the center since 6/2020 which poses an immediate health, safety or personal rights risk to persons in care. Civil Penalties assessed.
	POC Due Date: 05/04/2022
	Plan of Correction
1 2 3 4	By 5/4/22, director shall have the employee associated to the facility and submit proof of correction to LPA.

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

LICENSING EVALUATOR NAME:

Amanda Blesi

LICENSING EVALUATOR SIGNATURE:

DATE: 05/03/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2022

LIC809 (FAS) - (06/04)

Page: 3 of 4

Document Has Been Signed on 05/03/2022 01:08 PM - It Cannot Be Edited

Created By: Amanda Blesi On 05/03/2022 at 12:40 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: LITTLE SCHOOL HOUSE, THE	FACILITY NUMBER: 313609912
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/03/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.7995(a)(1)

General Provisions and Definitions

(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review the licensee did not comply with the section cited above in three out of four employee files reviewed did not contain proof of immunizaiton to MMR and Tdap which posesa potential health, safety or personal rights risk to persons in care.
	POC Due Date: 05/31/2022
	Plan of Correction
1 2 3 4	Director shall obtain proof of immunization for the 3 staff files indicated (see LIC811) and submit proof of correction to LPA by 5/31/22.

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

LICENSING EVALUATOR NAME:

Amanda Blesi

LICENSING EVALUATOR SIGNATURE:

DATE: 05/03/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2022

LIC809 (FAS) - (06/04)

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