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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313620596
Report Date: 10/04/2019
Date Signed: 10/04/2019 12:11:05 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:KIDZCOMMUNITY - ALTA VISTA HEAD START (PS)FACILITY NUMBER:
313620596
ADMINISTRATOR:RAMEY FAHRNEYFACILITY TYPE:
850
ADDRESS:173 OAK STREETTELEPHONE:
(530) 885-8466
CITY:AUBURNSTATE: CAZIP CODE:
95603
CAPACITY:18CENSUS: 15DATE:
10/04/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Ramey Fahrney - Site SupervisorTIME COMPLETED:
12:15 PM
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An unannounced annual/random inspection is made today by Licensing Program Analyst Owens and Blesi. LPA's Owens and Blesi met with Ramey Fahrney, Site Supervisor. A tour of facility was conducted inside and outside. Staff and children were spoken to during inspection.

The following areas are in compliance during inspection: There are no bodies of water. Firearms and ammunition are not on the premises. Storage area for poisons is locked. Disinfectants, hazardous items and medications are inaccessible to children. Furniture and equipment are sufficient, age appropriate and in good repair. Fire drills are conducted according to Title -22 Regulations. Facility has a carbon monoxide detector. The playground equipment and outdoor activity space is maintained and in good condition. There is adequate shade on playground. Wood chips is being used as cushioning around the climbing equipment. Children's toilets, hand washing facilities are sanitary. Rooms are safe and clean. Facility provides breakfast, lunch and snack to children. 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 at 45 degrees or less. Drinking water is available both indoors and outside. There is a shed on the playground that is locked. Menus are posted. The facility is in compliance with conditions and limitations specified on the license. Teacher/child ratios are maintained and adequate supervision is being provided during this inspection. Sign in/sign out sheets maintained. 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. Staff records reviewed contain documentation of the educational background, training, and/or experience. Operating hours are Monday thru Friday; 8:00 AM to 3:00 PM.

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SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Katrina OwensTELEPHONE: 916-263-6280
LICENSING EVALUATOR SIGNATURE:

DATE: 10/04/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2019
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: KIDZCOMMUNITY - ALTA VISTA HEAD START (PS)
FACILITY NUMBER: 313620596
VISIT DATE: 10/04/2019
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LPA observed proof that all staff/ volunteers have met the requirements of SB 792.
LPA observed that all staff has completed the required mandated reporter training (AB 1207) at website: www.mandatedreporterca.com.

Safe sleep were discussed with Site Supervisor at time of inspection.

LPA provided the Community Care Licensing website www.ccld.ca.gov, so the licensee can obtain updated licensing information, new regulations and access forms. LPA advised licensee 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.



No deficiencies observed in the areas inspected during today's inspection. This report was reviewed and discussed with the facility representative at the time of the inspection.

A COPY OF THIS REPORT MUST REMAIN IN THE FACILITY FOR PUBLIC REVIEW.
NOTICE OF SITE VISIT FORM POSTED TO PARENT'S BOARD FOR 30 DAYS.
SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Katrina OwensTELEPHONE: 916-263-6280
LICENSING EVALUATOR SIGNATURE:

DATE: 10/04/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2019
LIC809 (FAS) - (06/04)
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