343623908-7-9-2021-03-CC-MLOR-C4RP3F-20210709105728

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343623908
Report Date: 07/09/2021
Date Signed: 07/09/2021 10:57:37 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:	LIVING WATER PRESCHOOL ACADEMY		FACILITY NUMBER:	343623908
ADMINISTRATOR:	AWABDEH, MANAR		FACILITY TYPE:	840
ADDRESS:	2810 EASTERN AVENUE		TELEPHONE:	(916) 548-9756
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95821
CAPACITY:	24	CENSUS: 0	DATE:	07/09/2021
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Manar Awabdeh		TIME COMPLETED:	11:00 AM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Application Specialist (AS) Mai Lor and Licensing Program Manager (LPM) Seychelle De Luca met with Applicant Manar Awabdeh for the purpose of an announced pre-licensing inspection. Applicant requests a preschool license to serve 24 preschool children from age two to entry into first grade. The program will operate Monday through Friday from 8:00 AM to 4:00 PM. The fire clearance was granted on 5/4/21. Applicant acknowledges that the following documents must be posted at all times: License, Emergency Disaster Plan, Personal Rights, Parents' Rights Poster, Effects of Lead Exposure, car seat poster, menus, and daily schedule. AS provided and discussed LIC311A and the forms that must be in each child's and each staff member's file. The facility will provide morning and afternoon snacks and lunch. There is a water fountain at the front entrance. AS and LPM advised applicant regarding the health and safety of bodies of water. There are two separate buildings on the property which will not be utilized as part of the daycare. However, only staff will be utilizing the restroom located in one of the buildings. Applicant acknowledges that these buildings will not be used as part of the daycare. INDOOR ACTIVITY SPACE: There are two preschool classrooms: Classroom #1 and Classroom #2. AS and LPM observed a sufficient number of tables, chairs, cubbies, and napping cots for 24 preschool children. AS and LPM observed a variety of age-appropriate toys and equipment. There is a first aid kit in in the director's office. Medications will be stored in a locked cabinet in the director's office. AS and LPM observed cleaning disinfectants are appropriately stored and inaccessible to children. Applicant stated there are no poisons or firearms on the premises. AS and LPM observed water jugs in each of the classrooms. AS and LPM observed a functional carbon monoxide detector in each of the classrooms. AS and LPM observed paper sign-in/sign-out system. Report continues on 809-C.

SUPERVISOR'S NAME: Roxana Saravia	TELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Mai Lor	TELEPHONE: (916) 491-0182
LICENSING EVALUATOR SIGNATURE:	DATE: 07/09/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2021

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: LIVING WATER PRESCHOOL ACADEMY	FACILITY NUMBER: 343623908
	VISIT DATE: 07/09/2021

NARRATIVE

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AS measured two classrooms. The total classroom space contains a total of 1089.034 square feet, which accommodates Applicant's request for 24 preschool children. There are three toilets, one urinal and two sinks for the children, and a separate private restroom 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 office area and will use one of the stalls in the children's restroom, if necessary.

OUTDOOR ACTIVITY SPACE:
There is one outdoor area on the property for preschool children. The outdoor play area is fenced with combination wooden fence and wrought iron fence that is four feet tall. AS and LPM observed loose and/or broken fence panels. Nails were also observed protruding from the fence boards. The playground was observed to have metal pipes sticking from the ground, one large hole, and uneven asphalt. AS and LPM observed a variety of age-appropriate outdoor toys and equipment. Applicant stated they are planning on installing a play structure and will modify the playground to ensure health and safety. The playground is shaded by two canopies; however, additional shade will need to be provided.

AS and LPM measured the outdoor activity space. The outdoor play area contains a total of 10613.3 square feet, which accommodates Applicant's request for 24 preschool children. Individual measurements are recorded on the Capacity Worksheet (LIC 9024).

The facility's Plan of Operation is located in the preschool 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.

Report continues on 809-C.

SUPERVISOR'S NAME: Roxana Saravia	TELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Mai Lor	TELEPHONE: (916) 491-0182
LICENSING EVALUATOR SIGNATURE:	DATE: 07/13/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2021

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: LIVING WATER PRESCHOOL ACADEMY	FACILITY NUMBER: 343623908
	VISIT DATE: 07/09/2021

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AS and LPM discussed the following: 100% supervision is required at all times, including in the bathroom; personal rights; inspection authority; reporting requirements; staff to children ratios and capacity; staff qualifications; and maintaining buildings and grounds. AS and LPM 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. Fence panels need to be fixed and remove any protruding nails

2. Fix uneven asphalt on the playground

3. Remove metal pipes sticking from the ground

4. Fountain needs to filled with river rocks

5. Small door to the plumbing in the women's restroom is accessible

6. Water cooler for outside use

Applicant is to notify AS when all items are fixed and ready for a follow-up inspection.

Exit interview conducted.

SUPERVISOR'S NAME: Roxana Saravia	TELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Mai Lor	TELEPHONE: (916) 491-0182
LICENSING EVALUATOR SIGNATURE:	DATE: 07/09/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2021

LIC809 (FAS) - (06/04)

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