343603532-5-16-2019-03-CC-JBIK-BC8RNY-20190516131108

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343603532
Report Date: 05/16/2019
Date Signed: 05/16/2019 01:11:14 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME:	CHAMPIONS @ MARENGO RANCH ELEMENTARY		FACILITY NUMBER:	343603532
ADMINISTRATOR:	MCNAIRN, JANET		FACILITY TYPE:	840
ADDRESS:	1000 ELK HILLS DR.		TELEPHONE:	(209) 745-8737
CITY:	GALT	STATE: CA	ZIP CODE:	95632
CAPACITY:	50	CENSUS: 6	DATE:	05/16/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	12:10 PM
MET WITH:	Janet McNairn		TIME COMPLETED:	01:15 PM

NARRATIVE

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Licensing Program Analysts (LPAs) Jeevun Birk-Miller and Seychelle De Luca met with Director, Janet McNairn for the purpose of an unannounced annual random inspection. Director was reminded never to exceed the conditions, limitations, and capacity specified on the license. Census included 6 school-age children supervised by 2 staff members. Facility hours of operation are Monday through Friday from 7:00 AM to 6:00 PM. The program operates all day during breaks and operates 7:00 AM to 6:00 AM and 11:00 AM to 6:00 PM when school is in session.

LPA toured all activity and classroom spaces, restrooms, food service, and outdoor play areas. Currently no children require medications. Director stated that poisons are locked in a cabinet. Toxic and hazardous items are inaccessible to children. Furniture and equipment are in good condition. Playground equipment and surfaces are free of loose or sharp parts. The areas around or under climbing equipment are cushioned with bark to absorb the fall. Toileting facilities are in safe, sanitary and operating condition. The floors appeared clean throughout the facility. The food preparation space is free of litter and all food was protected against contamination. Storage containers with solid waste have tight-fitting covers. Program provides afternoon snack. Menus were posted and drinking water was readily available to children both indoors and outdoors. LPA observed full legal signatures while reviewing the sign-in and sign-out sheet as required for school- age component.

Staff and children's records were reviewed. Each child's file contained an emergency card and a consent for medical treatment. At least one staff member present today has current Pediatric CPR and First Aid certification (exp. 01/11/2020). All staff currently employed with the facility have a criminal record clearance, health screening report, and documentation of the educational background, training, and/or experience. There are no firearms or bodies of water on the premises. LPA observed a functional carbon monoxide detector.

Report continues on 809-C.

SUPERVISOR'S NAME: Maria Mayorga	TELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Jeevun Birk	TELEPHONE: (916) 263-1414
LICENSING EVALUATOR SIGNATURE:	DATE: 05/16/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2019

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: CHAMPIONS @ MARENGO RANCH ELEMENTARY	FACILITY NUMBER: 343603532
	VISIT DATE: 05/16/2019

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The facility's Plan of Operation is located in the facility file. Incidental Medical Services (IMS) policy was discussed and currently do not have any children who require services. IMS is provided by this facility. 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 athttp://www.ada.gov/childqanda.htm.

This facility evaluation report was reviewed and discussed with Program Coordinator. A Notice of Site Visit was provided and should remain posted for a period of 30 days for parental review. Program Coordinator was encouraged to the visit the department's website at WWW.CCLD.CA.GOV for information regarding child care updates, forms, regulations and legislation pertaining child care centers. LPA provided the Child Care Advocates Program email address: childcareadvocatesprogram@dss.ca.gov, so Program Coordinator can request to be added to the distribution list to receive Quarterly Updates. In the areas that were evaluated, no deficiencies were observed at the time of the visit.

SUPERVISOR'S NAME: Maria Mayorga	TELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Jeevun Birk	TELEPHONE: (916) 263-1414
LICENSING EVALUATOR SIGNATURE:	DATE: 05/16/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2019

LIC809 (FAS) - (06/04)

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