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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343612177
Report Date: 01/17/2020
Date Signed: 01/17/2020 12:55:08 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:SETA - GRIZZLY HOLLOW HEAD STARTFACILITY NUMBER:
343612177
ADMINISTRATOR:LOPEZ, MARLOFACILITY TYPE:
850
ADDRESS:805 ELK HILLS DRIVETELEPHONE:
(209) 744-7728
CITY:GALTSTATE: CAZIP CODE:
95632
CAPACITY:40CENSUS: 6DATE:
01/17/2020
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
10:32 AM
MET WITH:Marlo Lopez, Site SupervisorTIME COMPLETED:
12:10 PM
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Licensing Program Analyst (LPA) Jeevun Birk-Miller met with Site Supervisor, Marlo Lopez for the purpose of an unannounced annual inspection. Site Supervisor was reminded never to exceed the conditions, limitations and capacity specified on the license. Census included 6 preschool children with a total of five staff members present who all have obtained a criminal record clearance. This facility has a toddler option program. Facility hours of operation are Monday through Friday from 8:00 AM - 4:00 PM and offers two sessions. AM session from 8:00am to 11:30 AM and PM session from 12:30 PM to 4:00PM. The only children who nap are the children in the toddler room. The facility offers breakfast and lunch for the AM and lunch and snack for the PM. The food is prepared and delivered from the SETA centralized kitchen in Sacramento. Facility properly stores meals in a food warmer. Menus were posted and drinking water was readily available to children both indoors and outdoors. The food preparation space is free of litter and all food was protected against contamination. Storage containers with solid waste have tight-fitting covers.

LPA toured all activity and classroom spaces, restrooms, food service, and outdoor play areas. Medications are appropriately stored and inaccessible to children. Director stated there are no poisons, bodies of water or fire arms on the premises. 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 padding to absorb the fall. Toileting facilities are in safe, sanitary and operating condition. The floors appeared clean throughout the facility. LPA observed full legal signatures while reviewing the electronic sign-in and sign-out program.

Five children's records were reviewed. Each child's file contained an emergency card and a medical assessment. At least one staff member present today has current Pediatric CPR and First Aid certification, which expires on 3/8/2021.

Continue to 809-C page...
SUPERVISOR'S NAME: Jeanne SmithTELEPHONE: (916) 208-4405
LICENSING EVALUATOR NAME: Jeevun BirkTELEPHONE: (916) 917-6078
LICENSING EVALUATOR SIGNATURE:

DATE: 01/17/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2020
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: SETA - GRIZZLY HOLLOW HEAD START
FACILITY NUMBER: 343612177
VISIT DATE: 01/17/2020
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All staff currently employed with the facility have a health screening report. LPA verified documentation of the educational background, training, and/or experience. LPA reminded Site Supervisor that 100% supervision is required at all times, including in the bathroom. LPA observed a functional carbon monoxide detector. LPA reviewed the Department's inspection authority and discussed with Site Supervisor any changes that may occur regarding the director or an employee acting in the director's absence must be reported to department within ten working days. LPA discussed the new Immunization Card and the changes to the Mandated Reporter Training (AB1207). LPA provided and discussed the Effects of Lead Brochure and regulation information.

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: www.ada.gov/childqanda.

LPA verified the annual fees are current.

This facility evaluation report was reviewed and discussed with Site Supervisor; she stated she understands today's inspection. A Notice of Site Visit was provided and should remain posted for a period of 30 days for parental review. Site Supervisor 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. At this time no citations were given.

SUPERVISOR'S NAME: Jeanne SmithTELEPHONE: (916) 208-4405
LICENSING EVALUATOR NAME: Jeevun BirkTELEPHONE: (916) 917-6078
LICENSING EVALUATOR SIGNATURE:

DATE: 01/17/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2020
LIC809 (FAS) - (06/04)
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