313620674-5-24-2023-03-CC-LHAM-CS5NP6-20230524103749

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 313620674
Report Date: 05/24/2023
Date Signed: 05/24/2023 10:37:56 AM

Document Has Been Signed on 05/24/2023 10:37 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVER CITY (SACTO)CC, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME:	CARLIN C. COPPIN ELEMENTARY PS		FACILITY NUMBER:	313620674
ADMINISTRATOR:	QUINN, LAREE		FACILITY TYPE:	850
ADDRESS:	150 EAST 12TH STREET		TELEPHONE:	(530) 745-1380
CITY:	LINCOLN	STATE: CA	ZIP CODE:	95648
CAPACITY:	24	CENSUS: 8	DATE:	05/24/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Anna Gonzales		TIME COMPLETED:	10:45 AM

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On May 24, 2023 Licensing Program Analyst (LPA) Lea Habtom arrived to the Carlin C. Coppin Elementary school campus at approximately 9:15 am and checked in with the front office. LPA met with staff Anna Gonzales who was supervising 8 preschool children for the required 1 year annual inspection. The facility is located on Carlin C. Coppin Elementary school campus. All criminal record clearances are associated to this facility and Sierra College Rocklin State Preschool #313606938. Facility hours of operation are Monday through Friday from 8:00 am- 11:00 am and 12:00 pm- 3:00 pm.

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 toured the classroom, restroom, and outdoor play area. Staff stated there are no children who require medication. Toxic and hazardous items are inaccessible to children. Paper sign-in & sign-out sheets were observed with full signatures. Furniture and equipment are in good condition. Playground equipment and surfaces are free of loose or sharp parts. Sand and Wood chips are being used as cushioning around the climbing equipment and level is sufficient to absorb a fall. The program shares the kindergarten playground on the school campus. Toilets and faucets are in safe and operable conditions. The floors appeared clean throughout the facility. All food was protected against contamination. AM & PM snacks are provided by the program and no lunch is served due to two different part-time sessions. Children do not take naps as the program operates for 3 hours in two different sessions. Drinking water was readily available to children both indoors and outdoors. There are no firearms or bodies of water on the premises. LPA observed a functional carbon monoxide detector. Three staff and four children's records were reviewed. At least one staff member present today has current Pediatric CPR and First Aid certification. LPA reviewed the Department's inspection authority and discussed any changes that may occur regarding the director or an employee acting in the director's absence must be reported to department within 10 working days.

Report continued on 809-C.

SUPERVISOR'S NAME: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Lea Habtom	TELEPHONE: (916) 208-2538
LICENSING EVALUATOR SIGNATURE:	DATE: 05/24/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2023

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
RIVER CITY (SACTO)CC, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: CARLIN C. COPPIN ELEMENTARY PS	FACILITY NUMBER: 313620674
	VISIT DATE: 05/24/2023

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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

Staff are encouraged to the visit the Department's website at WWW.CDSS.CA.GOV for information regarding child care updates, forms, regulations and legislation pertaining child care centers.

This report was reviewed with staff member Anna Gonzales. Appeal rights and a notice of site visit provided. There were no Title 22 Deficiencies cited during today's inspection.

SUPERVISOR'S NAME: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Lea Habtom	TELEPHONE: (916) 208-2538
LICENSING EVALUATOR SIGNATURE:	DATE: 05/24/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2023

LIC809 (FAS) - (06/04)

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