340319034-11-10-2022-03-CC-GSIH-CL2Q93-20221110105740

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 340319034
Report Date: 11/10/2022
Date Signed: 11/10/2022 10:57:48 AM

Document Has Been Signed on 11/10/2022 10:57 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME:	NICHOLAS PRESCHOOL		FACILITY NUMBER:	340319034
ADMINISTRATOR:	ROSALIE NUGENT		FACILITY TYPE:	850
ADDRESS:	6601 STEINER DRIVE		TELEPHONE:	(916) 395-4658
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95823
CAPACITY:	24	CENSUS: 15	DATE:	11/10/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Theresa Perez		TIME COMPLETED:	11:10 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	Licensing Program Analysts (LPAs) Gagandeep Singh and Carla Polanco met with Director, Theresa Perez, for an annual inspection. Purpose of the inspection was explained. Present, there are 15 children in care with two staff and the director. Facility is operating with in the capacity and in compliance with staff child ratio on this day. Facility operates at school site from classroom K-3 from Monday to Friday between 8 AM to 6 PM. During inspection, LPAs inspected the classroom, Bathroom and the play yard. LPAs observed facility has smoke detector, carbon monoxide detector, fire pull alarm, 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. Facility has sufficient amount of sleeping matts. Facility floor is in good repair and free of any hazards. All toilets, hand washing facilities are in working condition with proper sanitation in place. Storage container for solid waste and in good repair and have proper tight-fitted lid on top. Facility has drinking water available for children. All the materials and surface accessible to the children is clean and toxic free. 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. During inspection, LPAs reviewed the facility records. LPAs observed that facility has sign in / out. Facility has license and all of the required documents posted and visible for public. LPAs reviewed random children's and all present staff's files. LPA observed facility has record of names, addresses and telephone numbers of each child's authorized representative. LPAs observed present staff member has record of valid CPR card in file. LPA reviewed the educational qualification of all the teachers. There are menus posted at least one week in advance and are visible to the child's authorized representative. See next page for continuation ........

SUPERVISOR'S NAME: Natalie Dunaway	TELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Gagandeep Singh	TELEPHONE: (916) 216-7823
LICENSING EVALUATOR SIGNATURE:	DATE: 11/10/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2022

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: NICHOLAS PRESCHOOL	FACILITY NUMBER: 340319034
	VISIT DATE: 11/10/2022

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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

The facility has fire drill log and per log the last drill was conduct on September 27, 2022. The facility is aware that all staff is required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com. LPAs observed the facility is using the Department approved vendor for the training and the completion certificates are on file.

LPA encourages the director to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates. Licensee 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 director. Notice of site visit is posted and shall remain posted for next 30 days.

SUPERVISOR'S NAME: Natalie Dunaway	TELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Gagandeep Singh	TELEPHONE: (916) 216-7823
LICENSING EVALUATOR SIGNATURE:	DATE: 11/10/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2022

LIC809 (FAS) - (06/04)

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