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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313623785
Report Date: 12/21/2021
Date Signed: 12/21/2021 12:40:33 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:LILY PAD EARLY LEARNING CENTERFACILITY NUMBER:
313623785
ADMINISTRATOR:THATCHER, STACIFACILITY TYPE:
850
ADDRESS:3330 CHISOM TRAILTELEPHONE:
(530) 863-9443
CITY:LOOMISSTATE: CAZIP CODE:
95650
CAPACITY:30CENSUS: 12DATE:
12/21/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:40 AM
MET WITH:Staci ThatcherTIME COMPLETED:
01:15 PM
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All times on this report are approximations. At 10:40 a.m. Licensing Program Analyst (LPA) Amanda Blesi met with Director, Stai Thatcher, for the purpose of an unannounced 1 year required inspection. A COVID-19 risk assessment was conducted at the door prior to entering the facility. Upon arrival LPA observed 12 preschool children on the playground supervised by three staff. Director guided LPA on a tour of the facility. All individuals subject to criminal background review have obtained criminal record clearance.

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 sanitary, and operating condition. Bins for solid waste in the kitchen have tight fitting lids. The floors appeared clean throughout the facility. Program provides Breakfast, lunch, and afternoon snacks.

There are functional water fountains indoors and outdoors. Children also have labeled water bottles. LPA observed full legal signatures while reviewing the sign in and sign out sheet. Playground equipment and surfaces are free of loose or sharp parts. LPA observed wood chip cushioning beneath the play structure. Outdoor shade is provided by trees and awnings. There are no firearms or bodies of water on the premises. There is a pond on the property next door and there is a 5 ft. wrought iron fence as a barricade. There was a gate that was observed to swing away from the pond and when tested was observed to self close and self latch. The carbon monoxide detector was built into the main fire alarm.

At 11:40 a.m., LPA reviewed staff files. At least one staff member present today has current Pediatric CPR and First Aid certification. LPA observed immunization records and documentation of the educational background, training, and/or experience. LPA observed updated AB 1207 Mandated Reporter training certificates. Director was advised that Mandated Reporter training must be renewed every two years and can be renewed at www.mandatedreporterca.com. (Report continues on 809-C)

SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Amanda BlesiTELEPHONE: (916) 208-3427
LICENSING EVALUATOR SIGNATURE:

DATE: 12/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 2
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: LILY PAD EARLY LEARNING CENTER
FACILITY NUMBER: 313623785
VISIT DATE: 12/21/2021
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At 11:55 a.m., LPA reviewed children's records. Each child's file contained an emergency card, consent for emergency medical treatment, health history and notifications of children’s and parent’s rights.

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.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


LPA discussed Assembly Bill 2370, which will require licensed Child Care facilities to test their water for excessive amounts of lead. Testing will be required beginning January 1st, 2020 to January 1st, 2023 and must be conducted every five years from initial testing.

Director was 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.


A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the facility representative Staci Thatcher. .
NO DEFICIENCIES WERE CITED DURING THIS INSPECTION.
Appeal Rights given. Exit interview conducted and report was reviewed with Staci Thatcher. 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 PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Amanda BlesiTELEPHONE: (916) 208-3427
LICENSING EVALUATOR SIGNATURE:

DATE: 12/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2021
LIC809 (FAS) - (06/04)
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