390310512-1-3-2020-53-CC-SWIS-BKGV24-20200103150231

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 390310512
Report Date: 01/03/2020
Date Signed: 01/03/2020 03:02:39 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:	BELLA VISTA CHRISTIAN ACADEMY		FACILITY NUMBER:	390310512
ADMINISTRATOR:	WAETZIG, LORI		FACILITY TYPE:	850
ADDRESS:	1635 CHESTER DRIVE		TELEPHONE:	(209) 835-7438
CITY:	TRACY	STATE: CA	ZIP CODE:	95376
CAPACITY:	96	CENSUS: 16	DATE:	01/03/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	12:15 PM
MET WITH:	Lori Waetzig		TIME COMPLETED:	03:15 PM

NARRATIVE

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Licensing Program Analysts (LPAs) Stacey Williams and Christopher Jackson met with Lori Waetzig, Director for the purpose of an unannounced annual random inspection. LPAs observed (16) sixteen children supervised by 4 staff. Criminal record clearances were verified.

Program hours are Monday through Friday 6AM-6PM. The program operates full day and half day programs. Program provides morning and afternoon snack. LPAs viewed the facility menu posted in the atrium of the center. LPAs viewed the kitchen area of the center. Food preparation area is clean, and food was covered, labeled and protected from contamination.

LPAs toured the facility inside and out. Capacity and ratio requirements were met. All cleaning supplies and hazardous items are stored in a locked cabinet inaccessible to children. Outdoor activity space and equipment was in good repair. Foam matting is being used as cushioning around the climbing equipment and level is sufficient to absorb a fall. Drinking water was readily available. Water bottles are used both inside and outside.

Restrooms were sanitary and in operating condition. Storage containers for solid waste had lids. Fire drills are conducted and documented. Carbon Monoxide and smoke detectors were present and operable.

LPAs reviewed a random sample of children files during the inspection. LPAs observed files included information pertaining to authorized representative, consent for medical treatment and a medical assessment form.

LPAs reviewed a random sample of staff records. LPAs did not observe current CPR/First Aid certification for staff present during today’s inspection. Immunization records, mandated reporter training completion certificate and documentation of educational background, training, and/or experience was verified in staff files.

Report Continues on 809-C

SUPERVISOR'S NAME: Maria Mayorga	TELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Stacey Williams	TELEPHONE: (916) 216-7797
LICENSING EVALUATOR SIGNATURE:	DATE: 01/03/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/03/2020

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: BELLA VISTA CHRISTIAN ACADEMY	FACILITY NUMBER: 390310512
	VISIT DATE: 01/03/2020

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Incidental Medical Services (IMS) policy was discussed. The facility currently has children utilizing incidental medical services. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing 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.

Title 22 deficiencies were observed during today’s inspection and will cited on subsequent page, LIC 809D.

This facility evaluation report was reviewed and discussed with Director, Lori Waetzig. The implementation of AB 2370, lead exposure was discussed, and handout was provided to the Director. Director 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 to child care centers.

Exit interview conducted. A notice of site visit was provided and should remain posted for a period of 30 days for parental review. Appeal Rights provided.

SUPERVISOR'S NAME: Maria Mayorga	TELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Stacey Williams	TELEPHONE: (916) 216-7797
LICENSING EVALUATOR SIGNATURE:	DATE: 01/03/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/03/2020

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: BELLA VISTA CHRISTIAN ACADEMY	FACILITY NUMBER: 390310512
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/03/2020

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 01/03/2020 Section Cited	1 2 3 4 5 6 7	Day care center directors and licensees of family day care homes shall ensure that at least one staff member who has a current course completion card in pediatric first aid and pediatric CPR issued by the American Red Cross, the American Heart Association, or by a training program that has been approved by the Emergency Medical Services Authority pursuant to this section and Section 1797.191 shall be onsite at all times when children are present at the facility, and shall be present with the children when children are offsite from the facility for facility activities. Nothing in this subdivision shall be construed to require, in the event of an emergency, additional staff members, who are onsite when children are present at the facility, to have a current course completion card in pediatric first aid and pediatric CPR.
	8 9 10 11 12 13 14	This requirement was not met as evidenced by: LPAs reviewed staff files and did not see current cpr/first aid certification for teachers present during today's inspection .	8 9 10 11 12 13 14
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Maria Mayorga	TELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Stacey Williams	TELEPHONE: (916) 216-7797
LICENSING EVALUATOR SIGNATURE:	DATE: 01/03/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/03/2020

LIC809 (FAS) - (06/04)

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