343623377-2-14-2020-03-CC-JHOA-BLSQF8-20200214110730

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343623377
Report Date: 02/14/2020
Date Signed: 02/14/2020 11:07:45 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:	FOLSOM PREPARATORY SCHOOL		FACILITY NUMBER:	343623377
ADMINISTRATOR:	MURAWSKI, CANDIS		FACILITY TYPE:	840
ADDRESS:	650 WILLARD DRIVE		TELEPHONE:	(916) 353-0185
CITY:	FOLSOM	STATE: CA	ZIP CODE:	95630
CAPACITY:	60	CENSUS: 0	DATE:	02/14/2020
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Candis Murawski		TIME COMPLETED:	11:30 AM

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Licensing Program Analysts (LPAs), Jan Hoshida, Kelly Ferrara and Christopher Jackson, met with Applicant, Candis Murawski, and Director, Diane Schlageter, for the purpose of an announced pre-licensing inspection. Applicant requests a school-age license to serve 60 school-age children from kindergarten and above. The program will operate Monday through Friday from 6:30 AM to 6:00 PM during the academic school year which runs from August through May. The fire clearance was granted on 1/7/20.

Applicant acknowledges that the following documents must be posted at all times: License, Emergency Disaster Plan, Personal Rights, Parents' Rights Poster, car seat poster, and daily schedule. LPA discussed the forms that must be in each child's and each staff member's file. LPA provided LIC311A, Effects of Lead Exposure brochure, and Healthy Schools Act survey. Applicant stated that children will be responsible for bringing their own breakfast, lunches and snacks. Applicant stated that they will have supplementary snacks on hand in case a child forgets their food or the facility will call parents to bring food for their child.

INDOOR ACTIVITY SPACE:
The facility will be utilizing the following four classrooms: room 3, 8, 13 and 14. LPAs observed a sufficient amount of equipment, tables and chairs. Applicant stated that children will place their personal belongings on hooks in the classroom. There are first aid kits in each classroom. Medications will be stored in the front office area in a locked drawer. LPAs observed cleaning disinfectants are appropriately stored and inaccessible to children. Applicant stated there are no poisons or firearms on the premises. Applicant stated that children will bring their own water bottles for water accessibility in the classrooms. LPAs observed a sign-in/sign-out system.

LPAs did not observe a functioning carbon monoxide detector during the inspection. Applicant stated that she will purchase two carbon monoxide detectors and install them within the facility.

Report continues on 809-C.

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Jan Hoshida	TELEPHONE: (916) 917-6572
LICENSING EVALUATOR SIGNATURE:	DATE: 02/14/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2020

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: FOLSOM PREPARATORY SCHOOL	FACILITY NUMBER: 343623377
	VISIT DATE: 02/14/2020

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LPAs measured four classrooms. The total classroom space contains a total of 2,036.832 square feet, which will accommodate 58 school-age children. There are 12 toilets, 2 urinals and 10 sinks for the children, and two separate private restrooms for the staff. Individual measurements are recorded on the Capacity Worksheet (LIC 9024). Children who become ill during the day will be isolated in the front office area and will use the staff restroom, if necessary.

During the inspection, Applicant submitted a new application for an updated licensed capacity for a total capacity of 58 school age children. Applicant understands that she must submit a waiver request to share the facility restrooms with the private school program.

The facility is located on a private school campus and the Applicant stated that the day care children will be physically separate at all times from the other children on campus.

OUTDOOR ACTIVITY SPACE:
There is one school-age outdoor area on the property. The outdoor play area is fenced with a wrought iron fence that is at least four feet tall. LPAs observed a sufficient amount of equipment and toys. There are no bodies of water on the premises. There are shaded areas supplied by trees.

LPAs measured the outdoor activity space. The outdoor play area contains a total of 18,863.57 square feet, which will accommodate Applicant's updated request for 58 school age children. Individual measurements are recorded on the Capacity Worksheet (LIC 9024).

California Code of Regulations, Title 22, Division 12, Section 101538.2 outdoor activity space provided for school-age child care center children shall be physically separated from other children. Applicant understands that she must submit a waiver request to share the outdoor activity space with the private school program which specifies the rotation schedule for outdoor activity play times.

Report continues on 809-C.

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Jan Hoshida	TELEPHONE: (916) 917-6572
LICENSING EVALUATOR SIGNATURE:	DATE: 02/14/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2020

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: FOLSOM PREPARATORY SCHOOL	FACILITY NUMBER: 343623377
	VISIT DATE: 02/14/2020

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The facility's Plan of Operation is located in the facility file. Incidental Medical Services and a Plan of Operation is located in the facility 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.

LPAs discussed the following: supervision; personal rights; inspection authority; reporting requirements; staff to children ratios and capacity; staff qualifications; and maintaining buildings and grounds. LPAs discussed with Applicant any changes that may occur regarding the director or an employee acting in the director's absence must be reported to department within 10 working days.

This facility evaluation report was reviewed and discussed with Applicant. Applicant was encouraged to the visit the Department's website at WWW.CDSS.CA.GOV for information regarding child care updates, forms, regulations and legislation pertaining to child care centers.

The following items are required before a license will be issued:

1. Waiver requests for shared bathroom usage and outdoor activity space

2. Proof of installation of carbon monoxide detectors

3. Remaining paperwork

4. LPM’s final file review

5. Updated fire clearance with new capacity

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Jan Hoshida	TELEPHONE: (916) 917-6572
LICENSING EVALUATOR SIGNATURE:	DATE: 02/14/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2020

LIC809 (FAS) - (06/04)

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