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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 340319034
Report Date: 09/20/2021
Date Signed: 09/20/2021 03:51:55 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:NICHOLAS PRESCHOOLFACILITY NUMBER:
340319034
ADMINISTRATOR:ROSALIE NUGENTFACILITY TYPE:
850
ADDRESS:6601 STEINER DRIVETELEPHONE:
(916) 433-5079
CITY:SACRAMENTOSTATE: CAZIP CODE:
95823
CAPACITY:24CENSUS: 8DATE:
09/20/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Karen HuynhTIME COMPLETED:
04:10 PM
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Licensing Program Analyst (LPA) Gagandeep Singh met with the facility representative, Karen Huynh, for an annual inspection. Purpose of the inspection was explained. Present, there are eight children with two staff. Facility is operating with in the capacity and in compliance with staff child ratio on this day. Facility operates at the Nicholas elementary school site from Monday to Thursday between 8:30 AM to 12 Noon and 12:30 PM to 3:30 PM. On Fridays, the facility operates between 12:30 PM to 3:30 PM.

During the inspection, LPA inspected the day care classroom, Bathroom and Play yard. There are no pools, spas or other bodies of water at the facility. Facility has smoke detector, carbon monoxide detector, fully charged fire extinguisher and working telephone at the site. All of the cleaning solutions, poisons and other chemicals that are dangerous to the children are stored inaccessible to the children. Facility has age appropriate furniture. Furniture is steady and in good repair. All toilets, hand washing facilities are in working condition with proper sanitation in place. LPA reminded the facility representative that all storage containers for solid waste must have proper tight-fitted lid on top. Facility has drinking water available for children. There are first aid supplies available in the classroom. All of the unused electrical outlets have child protective covers installed. Play yard is free of hazards. All of the play structures are steady, in good repair and free of any loose parts. There is sufficient amount of wood chips under the play structures to prevent any fall injuries. There is plenty of shaded area in the play yard. Staff member brings the drinking water with them to the play while children play.

LPA reviewed the facility records. LPA observed that facility has sign in / out record with full legal signatures. Facility has well maintained roster available on site. LPA observed facility has license and all of the other required documents posted and are visible for public. LPA reviewed all present children's and staff's files. LPA observed facility has record of names, addresses and telephone numbers of each child's authorized representative. Staff member has record of valid CPR card in file. LPA reviewed the educational qualification of all the teachers.
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SUPERVISOR'S NAME: Maria MayorgaTELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Gagandeep SinghTELEPHONE: (916) 216-7823
LICENSING EVALUATOR SIGNATURE:

DATE: 09/20/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2021
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: NICHOLAS PRESCHOOL
FACILITY NUMBER: 340319034
VISIT DATE: 09/20/2021
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LPA observed facility has well maintained children roster on file. LPA reminded the facility representative that fire drills must be conducted once at least every six months and drills must be documented. Facility has a log in place. LPA reminded the facility representative that a person may not be employed or volunteer at a child care facility unless he or she has been immunized against influenza, pertussis, and measles or qualifies for an exemption pursuant to Health and Safety code 1596.7995 and 1597.662.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. 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 review AB 1207 with the facility representative and informed that all staff is required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com. Facility is using Department approved vendor for the training. LPA observed the completion certificates on file.



LPA encourages the facility to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates. Facility can also email at childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list for the updates.

No deficiencies are cited today. The copy of this report is reviewed and provided to the facility representative. Notice of site visit is posted and shall remain posted for next 30 days.
SUPERVISOR'S NAME: Maria MayorgaTELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Gagandeep SinghTELEPHONE: (916) 216-7823
LICENSING EVALUATOR SIGNATURE:

DATE: 09/20/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2021
LIC809 (FAS) - (06/04)
Page: 2 of 2