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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313623395
Report Date: 11/02/2022
Date Signed: 11/02/2022 01:18:37 PM

Document Has Been Signed on 11/02/2022 01:18 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:GUIDING STARS ACADEMYFACILITY NUMBER:
313623395
ADMINISTRATOR:SHEPARD, MALLORYFACILITY TYPE:
830
ADDRESS:595 A STREETTELEPHONE:
(916) 645-1099
CITY:LINCOLNSTATE: CAZIP CODE:
95648
CAPACITY: 16TOTAL ENROLLED CHILDREN: 16CENSUS: 10DATE:
11/02/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Amber Williams, Assistant DirectorTIME COMPLETED:
01:45 PM
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All times on this report are approximate. At 11:30am, Licensing Program Analyst (LPA) Amanda Blesi arrived at the facility and met with Assistant Director Amber Williams for a required 1-year unannounced Annual inspection. LPA toured the facility inside and out including all activity and classroom spaces, restrooms, food service and outdoor play areas. Hours of operation are Monday through Friday from 7:00 AM to 6:00 PM. Upon arrival there were 3 toddlers and seven infants under 12 months supervised by 3 staff.

Toxic and hazardous items are appropriately stored and inaccessible to infants. Furniture and materials are in good condition. Playground equipment and surfaces are free of loose or sharp parts. Changing table was within arms reach of a sink. Sufficient napping equipment was available. LPA reminded the Director that napping infants must have 100% visual supervision at all times. All food was protected against contamination. Trash cans containing solid waste had lids. Drinking water was readily available to children both indoors and outdoors. Menus were posted. Sign in and sign out sheets were maintained. LPA reminded staff that infant bottles, dishes and containers must be labeled and dated per regulation section 101427(j). LPA also discussed the requirement of washing children's bedding at least once daily. LPA observed proper storage of medication, equipment and supplies. 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.

(Report continued on LIC 809-C)

Keven Peters
Amanda Blesi
DATE: 11/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/02/2022
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: GUIDING STARS ACADEMY
FACILITY NUMBER: 313623395
VISIT DATE: 11/02/2022
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LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee [facility representative] of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment

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

A sample of children's records were reviewed. Quarterly updated Needs & Services plans were observed. A sample of staff records were reviewed. At least one staff member present today has current Pediatric CPR and First Aid training certification. Completion of AB1207 Mandated Reporter Training was verified. No baby walkers, infant bouncers, saucer chairs, Johnny Jumpers, or taco sleepers were observed on the premises. There are no firearms or bodies of water on the premises. LPA reviewed Departments inspection authority and discussed with designee any changes that may occur regarding the director or an employee acting in the director's absence must be reported to department

Exit interview conducted and report was reviewed with the licensee facility representative Amber Williams. 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.
SUPERVISOR'S NAME: Keven Peters
LICENSING EVALUATOR NAME: Amanda Blesi
LICENSING EVALUATOR SIGNATURE:

DATE: 11/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2022
LIC809 (FAS) - (06/04)
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