313610656-1-17-2020-03-CC-ABLI-BKWRHX-20200117120304

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 313610656
Report Date: 01/17/2020
Date Signed: 01/17/2020 12:03:10 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:	PACIFIC OAKS PRESCHOOL		FACILITY NUMBER:	313610656
ADMINISTRATOR:	CLEMMER, PAULA		FACILITY TYPE:	850
ADDRESS:	4500 PACIFIC ST. #F		TELEPHONE:	(916) 630-1688
CITY:	ROCKLIN	STATE: CA	ZIP CODE:	95677
CAPACITY:	51	CENSUS: 34	DATE:	01/17/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	10:45 AM
MET WITH:	Paula Clemmer Owner		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	Licensing Program Analyst Amanda Blesi conducted an unannounced random annual inspection today. LPA met with Paula Clemmer, director. LPA observed five staff supervising 34 children upon arrival. A tour of the facility was conducted inside and outside. The following areas are in compliance during the visit. There are no bodies of water observed. Firearms and ammunition are not on the premises. Storage for poisons are locked. Disinfectants, hazardous items and medications are inaccessible to children. Furniture and equipment are sufficient, age appropriate and in good repair. The last fire drill was conducted in October 2019. Carbon Monoxide detector was present. The playground equipment and outdoor activity space is maintained and in good condition. Cushioning under the climbing equipment is sufficient to absorb a fall. Children's toilets, hand washing facilities are sanitary. Floors are clean and free of debris. Food preparation area is clean, food is protected from contamination, storage containers for solid waste are covered and all food or beverages are stored in covered containers. Drinking water is available both indoors and outside. Menus are posted. The facility is in compliance with conditions and limitations specified on the license. Sign in/sign out sheets are maintained electronically. No excluded individuals are present. 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. Some staff records were reviewed.

SUPERVISOR'S NAME: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Amanda Blesi	TELEPHONE: (916) 208-3427
LICENSING EVALUATOR SIGNATURE:	DATE: 01/17/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2020

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: PACIFIC OAKS PRESCHOOL	FACILITY NUMBER: 313610656
	VISIT DATE: 01/17/2020

NARRATIVE

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LPA provided the Community Care Licensing’s website www.ccld.ca.gov, so the director can obtain updated licensing information, new regulations and access forms. LPA advised the director of their responsibility to stay current in regards to new regulations. LPA also included the email address for the children's advocacy program to stay current on new laws childcareadvocatesprogram@dss.ca.gov.

LPA provided and discussed the Lead Testing brochure (AB 2370) and updated Blue Immunization Cards (CDPH 286)

Mandated Reporter Training
The training can be taken online at: mandatedreporterca.com. LPA verified staff files contained proof of mandated reporter training. Director understands the training needs to be renewed every two years.
IMS
This facility provides Incidental Medical Services – IMS. 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

Per California Code of Regulations, Title 22, Division 12, Chapter 1, no deficiencies were cited during today's inspection.

Licensing report was reviewed and discussed with Mrs. Clemmer LPA provided a Notice of Site Visit and the Licensee acknowledges that this notice should remain posted for 30 days for parental review.

SUPERVISOR'S NAME: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Amanda Blesi	TELEPHONE: (916) 208-3427
LICENSING EVALUATOR SIGNATURE:	DATE: 01/17/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2020

LIC809 (FAS) - (06/04)

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