390319170-10-22-2019-53-CC-ASIS-BH7PUA-20191022113714

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 390319170
Report Date: 10/22/2019
Date Signed: 10/22/2019 11:37:21 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:	HERITAGE STATE PRESCHOOL		FACILITY NUMBER:	390319170
ADMINISTRATOR:	WISE, STACY		FACILITY TYPE:	850
ADDRESS:	509 E. EDEN		TELEPHONE:	(209) 331-7233
CITY:	LODI	STATE: CA	ZIP CODE:	95240
CAPACITY:	47	CENSUS: 38	DATE:	10/22/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Stacy Wise		TIME COMPLETED:	12:00 PM

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Licensing Program Analyst (LPA) Alecia Sifuentes met with Director, Stacy Wise the purpose of an unannounced annual random inspection. Director was reminded never to exceed the conditions, limitations and capacity specified on the license. Census included thirty-eight preschoolers being supervised by four staff members during nap time. Facility hours of operation are Monday through Friday from 8:00 AM to 2:00 PM.

LPA toured the building including all activity and classroom spaces, restrooms, and outdoor play areas. Medications are stored appropriately and are inaccessible to children. Poisons are not kept on 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. The floors appeared clean throughout the facility. The food preparation space is free of litter and all food was protected against contamination. LPA observed that storage containers for solid waste have tight-fitting covers. Program provides snack and lunch. Menus were posted and drinking water was readily available to children both indoors and outdoors. LPA observed parents are signing in/out properly through the facility sign-in and out binders.

Two staff files and four children's records were reviewed. Each child's file contained an emergency card and medical assessment, and immunizations. At least one staff member present today has current Pediatric CPR and First Aid certification that expires on 3/2/2021. All staff currently employed with the facility have a criminal record clearance, health screening report, and documentation of the educational background, training, and/or experience. LPA reminded Director that 100% supervision is required at all times, including during nap time. LPA advised the Director on the new Safe Sleep Regulations and Effects of Lead.

Report continues on 809-C.

SUPERVISOR'S NAME: Jeanne Smith	TELEPHONE: (916) 208-4405
LICENSING EVALUATOR NAME: Alecia Sifuentes	TELEPHONE: (916) 917-9202
LICENSING EVALUATOR SIGNATURE:	DATE: 10/22/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2019

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: HERITAGE STATE PRESCHOOL	FACILITY NUMBER: 390319170
	VISIT DATE: 10/22/2019

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There are no firearms or bodies of water on the premises. LPA observed a functional carbon monoxide detector. LPA reviewed the Department's inspection authority and discussed with Director 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.

LPA discussed the new Mandated Reporter Training with licensee. Beginning January 1, 2018, Health and Safety Code 1596.8662 requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Volunteers are encouraged but not required to take the training. In addition, existing licensees must meet requirements by March 30, 2018. This training requirement may be met by using the Department’s Office of Child Abuse Prevention (OCAP) online training modules. The OCAP modules are free of cost and available at: http://www.mandatedreporterca.com/. The training is currently provided in English.

This facility provides Incidental Medical Services- IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. 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.

This facility evaluation report was reviewed and discussed with Director. A Notice of Site Visit was provided and should remain posted for a period of 30 days for parental review. LPA provided the Child Care Advocates Program email address: childcareadvocatesprogram@dss.ca.gov. 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 child care centers.

In the areas that were evaluated, no deficiencies were observed at the time of the visit.

SUPERVISOR'S NAME: Jeanne Smith	TELEPHONE: (916) 208-4405
LICENSING EVALUATOR NAME: Alecia Sifuentes	TELEPHONE: (916) 917-9202
LICENSING EVALUATOR SIGNATURE:	DATE: 10/22/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2019

LIC809 (FAS) - (06/04)

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