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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343621719
Report Date: 09/20/2019
Date Signed: 09/20/2019 10:39:17 AM

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:VINELAND PRESCHOOLFACILITY NUMBER:
343621719
ADMINISTRATOR:CUNNION, ELIZABETHFACILITY TYPE:
850
ADDRESS:6450 20TH STREETTELEPHONE:
(916) 566-1616
CITY:RIO LINDASTATE: CAZIP CODE:
95673
CAPACITY:30CENSUS: 13DATE:
09/20/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Kalysia JohnsonTIME COMPLETED:
10:45 AM
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LPA Kelly met with Kalysia Johnson, Site Supervisor to conduct an annual inspection. LPA toured the inside and outside of the facility, including activity/classroom area, restroom and outdoor play area. LPA reviewed care and supervision of children, staffing ratios, health related services, including first aid supplies, furniture, equipment, drinking water and food service provisions. LPA observed a total of 13 children with 2 teachers. There was sufficient staff to meet ratio requirements.

LPA observed 1 toilet and 1 sink for use by the children. LPA observed a separate staff bathroom which was inaccessible to the children. Staff stated there is one on medication. Cleaning supplies were out of reach of children. LPA observed children's toys were in good condition and in sufficient supply. There were no children currently taking medication. LPA discussed and reviewed Health & Safety code: 1596.7995 Employees or volunteers at day care center; immunization requirements; records; exemptions with applicant.

Program operates an AM class Monday - Friday, from 7:00am to 5:00pm. Children are served: Breakfast, Lunch and Snack - meals are provided from the District.

LPA observed that all of the required forms were posted including a license, meal/snack menu that meets regulation, parents' rights' poster, emergency care and disaster plan and seat belt law.

LPA reviewed the sign/in-sign/out sheet, children's and personnel records. At least on staff member present today have current a Pediatric CPR and First Aid.

LPA did not observe any Title 22 Regulation deficiencies.

Notice of Site Visit Posted.
SUPERVISOR'S NAME: Roxana SaraviaTELEPHONE: (916) 263-5744
LICENSING EVALUATOR NAME: Socorro KellyTELEPHONE: (916)216-7792
LICENSING EVALUATOR SIGNATURE:

DATE: 09/20/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2019
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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