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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313620596
Report Date: 08/31/2022
Date Signed: 08/31/2022 03:21:27 PM


Document Has Been Signed on 08/31/2022 03:21 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: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: 9DATE:
08/31/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Ramey FahrneyTIME COMPLETED:
03:45 PM
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On August 31, 2022, Licensing Program Analyst (LPA) Lea Habtom met with Director, Ramey Fahrney, for the purpose of an unannounced required 1 year inspection. Operating hours of the facility are from 8:00 a.m.-2:30 p.m., Monday thru Friday. Director guided LPA on a tour of the facility, at which time a census of 9 preschool children supervised by 2 staff was observed.

All individuals subject to criminal background review have obtained criminal record clearance. Director 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.

A health and safety inspection was conducted in the classrooms, restrooms, food service areas, and outdoor play areas. 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. Director stated there are no poisons on the premises. Furniture and equipment are in good condition, and toileting facilities are in safe, sanitary, and operating condition. Bins for solid waste in the have tight fitting lids. The floors appeared clean throughout the facility. The facility provides breakfast, lunch, and afternoon snack. The food preparation space is free of litter and all food was protected against contamination. Drinking water was readily available with personal labeled water bottles. LPA observed full legal signatures of authorized representatives. There are no firearms or bodies of water on the premises. LPA observed a functional carbon monoxide detector. Playground equipment and surfaces are free of lose sharp objects.

Report continued on 809-C (Page 1)

SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Lea HabtomTELEPHONE: (916) 208-2538
LICENSING EVALUATOR SIGNATURE:
DATE: 08/31/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/31/2022
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: KIDZCOMMUNITY - ALTA VISTA HEAD START (PS)
FACILITY NUMBER: 313620596
VISIT DATE: 08/31/2022
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LPA observed wood chip cushioning beneath the play structure. Outdoor shade is provided by trees.

Staff files were reviewed. At least one staff member present today has current Pediatric CPR and First Aid certification on 8/2023. LPA observed immunization records and documentation of the educational background, training, and/or experience and AB 1207 Mandated Reporter training certificates.

Children's records were reviewed. Each child's file contained an emergency card, consent for emergency medical treatment and notifications of children’s and parent’s rights, health history, physician's report and immunization records. LPA observed signed form LIC224 Acknowledgement of receipt of licensing reports.

This facility provides Incidental Medical Services – IMS but no children are currently on medication. A plan of operation is on file at the facility. 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.

LPA verified the annual fees are current.

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.

In the areas that were evaluated, no deficiencies were cited during today’s inspection. Exit interview conducted and report was reviewed with Ramey Fahrney. A notice of site visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Lea HabtomTELEPHONE: (916) 208-2538
LICENSING EVALUATOR SIGNATURE:

DATE: 08/31/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2022
LIC809 (FAS) - (06/04)
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