325407786-9-11-2020-13-CC-SHUD-BTCQ32-20200911114802

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 325407786
Report Date: 09/11/2020
Date Signed: 09/11/2020 11:49:08 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME:	QUINCY HEAD START		FACILITY NUMBER:	325407786
ADMINISTRATOR:	TOLEN, LEASA		FACILITY TYPE:	850
ADDRESS:	175 NORTH MILL CREEK ROAD		TELEPHONE:	(530) 283-0592
CITY:	QUINCY	STATE: CA	ZIP CODE:	95971
CAPACITY:	24	CENSUS: 0	DATE:	09/11/2020
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	10:05 AM
MET WITH:	Leasa Tolen, Site Supervisor		TIME COMPLETED:	11:30 AM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	The facility pre-licensing inspection was conducted via tele-inspection due to the current state of emergency regarding the COVID-19 outbreak by Licensing Program Analyst (LPA), Sandy Husband. The applicant has applied for a change of location with a capacity of 24 preschool age children. The facility was toured inside and outside and is located on the Pioneer Elementary School campus. The operational hours are from 7:45 AM to 1:45 PM, Monday - Thursday during COVID. The preschool facility consists of 1 classroom serving ages 3 to 5 years old. The fire clearance was approved for 24 preschoolers on 7/21/20. The indoor capacity measured for 25 preschoolers and the outdoor yard area measured for 27 children. Required postings (Parents Personal Rights, Emergency Disaster Plan, Earthquake Preparedness Checklist, Menu, etc.) listed on Form LIC 311A are posted. The applicant was advised that all staff are required to have a criminal background clearance on file with Community Care Licensing (CCL). The applicant is aware of the immediate $100 per day civil penalty for anyone providing care or supervision without a criminal record clearance. The Director meets the required qualifications. The applicant/Site Supervisor will maintain current on Pediatric CPR and First Aid and expires on 9/2021. The Site Supervisor has obtained Mandated Reporter Training which expires 10/2/2021. Children will use the fenced outdoor play area. Sign-In/Out procedure were reviewed. The applicant/Site Supervisor understands that if a manual Sign-In/Out procedure is used, full legal signatures are required. Cubbies are available for children to use. There are pull fire alarms, and there is a working carbon monoxide detector and charged fire extinguisher in the facility rated at least the 2A10BC. All Exits are marked. There is 1 bathroom available to children with 2 toilets and 1 sink; there is an additional sink located in the classroom. There is one staff bathroom, which is separate. There is uncontaminated drinking water available to children both indoors via individual disposable cups and outdoors with an igloo and individual disposable cups. The isolation area for a sick child will be established in the Site Supervisor's office with a mat and blankets.The facility has a current menu and the Plumas (Continued on LIC 809-C)

SUPERVISOR'S NAME: Megan Aviles	TELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Sandra Husband	TELEPHONE: 530-895-5822
LICENSING EVALUATOR SIGNATURE:	DATE: 09/11/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2020

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, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME: QUINCY HEAD START	FACILITY NUMBER: 325407786
	VISIT DATE: 09/11/2020

NARRATIVE

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(Continued from LIC 809)
Unified School District will be providing breakfast and lunch on site and the preschool will provide snack. Children will nap with individual cots and bedding is kept separately in each child's sealed tub and will be washed weekly.
(Continued from LIC 809)

Age appropriate toys and activities are available for children. There is wood chip cushioning material underneath the play structures sufficient to absorb falls. There is a tree present to provide shade along with a canopy in the play yard. There are no bodies of water located on the property and none are to be added without prior notification and approval of the licensing agency. 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. This report, as well as the Guide to Safe Sleep Practices brochure and Lead Exposure Testing Flyer, were reviewed and discussed with the applicant/Site Supervisor. All licensing reports are public information and must be made available upon request for at least three years.

Any proposed changes to the physical plant, telephone number, or change of address shall be immediately reported to the Department.

The following items must be submitted prior to licensure:

1. Lock on the playground gate leading to another outside area.
2. A barrier secured in between the fence and building to prevent a child from escaping.

SUPERVISOR'S NAME: Megan Aviles	TELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Sandra Husband	TELEPHONE: 530-895-5822
LICENSING EVALUATOR SIGNATURE:	DATE: 09/11/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2020

LIC809 (FAS) - (06/04)

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