343614437-9-23-2019-03-CC-TWAN-BGAS99-20190923134024

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343614437
Report Date: 09/23/2019
Date Signed: 09/23/2019 01:40:31 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:	KOHLER PRESCHOOL		FACILITY NUMBER:	343614437
ADMINISTRATOR:	HUA LOR		FACILITY TYPE:	850
ADDRESS:	4004 BRUCE WAY		TELEPHONE:	(916) 566-1850
CITY:	NORTH HIGHLANDS	STATE: CA	ZIP CODE:	95660
CAPACITY:	72	CENSUS: 28	DATE:	09/23/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	12:20 PM
MET WITH:	Hua Lor		TIME COMPLETED:	02:00 PM

NARRATIVE

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Licensing Program Analysts (LPAs) Tanya Washington and Christopher Bello met with Site Supervisor Hua Lor for the purpose of an unannounced annual random inspection. Licensing Representative Elizabeth Cunnion arrived during the inspection to assist with the visit. Staff was reminded never to exceed the conditions, limitations, and capacity specified on the license. LPAs observed care and supervision of 15 napping children in room #3 supervised by 2 staff. LPAs observed 13 children on the playground connected to classroom #2 supervised by 2 staff. Room #3 operates 7 AM to 5 PM and room #2 operates from 8 AM to 3 PM. Classroom #10 is not in use during the school year and may open in the summer for additional enrollment. The program is open year around.

LPAs toured the classrooms, restrooms, and outdoor play area. LPAs reviewed storage of medication and expiration dates. Site Supervisor stated there are no poisons 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. There is a play structure on the playground which is shared with the elementary school the safety label indicates age limitation for children ages 5 to 12 years old. Site Supervisor acknowledges that children under 5 years shall not play on the play structure. Toileting facilities are in safe, sanitary, and operating condition. The floors appeared clean throughout the facility.

Storage containers with solid waste have tight-fitting covers. Program provides breakfast, lunch and supper, the food is delivered to the classroom by the school district. Menus were posted and drinking water was readily available to children both indoors and outdoors. LPAs observed a manual sign in and out book with full legal signatures.

Staff and 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 (exp. 08/10/20).

Report continues on LIC809-C.

SUPERVISOR'S NAME: Roxana Saravia	TELEPHONE: (916) 263-5744
LICENSING EVALUATOR NAME: Tanya Washington	TELEPHONE: 916-879-1209
LICENSING EVALUATOR SIGNATURE:	DATE: 09/23/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2019

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: KOHLER PRESCHOOL	FACILITY NUMBER: 343614437
	VISIT DATE: 09/23/2019

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All staff currently employed with the facility have a criminal record clearance through the school district and documentation of the educational background, training, and/or experience. LPAs reminded Site Supervisor that 100% supervision is required at all times, including in the bathroom. There are no firearms or bodies of water on the premises. LPAs observed a functional carbon monoxide detector. LPAs reviewed the Department's inspection authority and discussed with designee 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.

A Plan of Operation is located in the Administrative file. 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 provided the following link:http://www.cdss.ca.gov/inforesources/Community-Care-Licensing/subscribe for the Site Supervisor to subscribe to the distribution list and receive Quarterly Updates. Lead Exposure brochure was provided and discussed.

This facility evaluation report was reviewed and discussed with Elizabeth Cunnion. Staff 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. An exit interview was conducted.

Notice of site visit posted. No deficiencies are observed during today's inspection.

SUPERVISOR'S NAME: Roxana Saravia	TELEPHONE: (916) 263-5744
LICENSING EVALUATOR NAME: Tanya Washington	TELEPHONE: 916-879-1209
LICENSING EVALUATOR SIGNATURE:	DATE: 09/23/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2019

LIC809 (FAS) - (06/04)

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