393601775-1-17-2020-53-CC-CJAN-BKWSRM-20200117130633

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 393601775
Report Date: 01/17/2020
Date Signed: 01/17/2020 01:06:50 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:	COUNTRY KIDS CHILD DEVELOPMENT CENTER		FACILITY NUMBER:	393601775
ADMINISTRATOR:	BRIGGS, DAWN		FACILITY TYPE:	840
ADDRESS:	1301 MILLER AVE		TELEPHONE:	(209) 838-1600
CITY:	ESCALON	STATE: CA	ZIP CODE:	95320
CAPACITY:	28	CENSUS: 0	DATE:	01/17/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Dawn Briggs		TIME COMPLETED:	01:15 PM

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	Licensing Program Analysts (LPAs) Christopher Jackson and Charlotte Baney conducted an unannounced random annual inspection on 01/17/2020. LPAs met with license/director Dawn Briggs. A tour of the facility was conducted inside and outside. The following areas are in compliance during the visit. There are no bodies of water. Firearms and ammunition are not on the premises. Storage for poisons are locked. Disinfectants, hazardous items and medications are inaccessible to children. Furniture and equipment are sufficient, age appropriate and in good repair. Fire drills are conducted and documented. Carbon Monoxide, and Smoke detectors were present during today's inspection. There are five playground areas on the grounds. The small play yard located in the front of the facility is for the toddler option component. LPAs observed the equipment and outdoor activity space is maintained and in good condition. Wood chips are being used as cushioning around the climbing equipment and level is sufficient to absorb a fall. LPAs discussed replenishing the bark in the front right play area. Children's toilets, hand washing facilities are sanitary. Floors are clean and free of debris. Food preparation area is clean, food is protected from contamination, trash containers for solid waste are covered and all food or beverages are stored in covered containers and labeled. The licensee stated the facility only provides a PM snack and lunches are provided by families. Licensee stated an AM snack is provided to school age children during the summer program. LPAs observed menus are posted. Drinking water is available both indoors and outside. The facility is in compliance with conditions and limitations specified on the license. The facility utilizes an electronic Sign in/sign out process. No excluded individuals are present. Staff subject to a criminal record clearance or exemption are associated to the facility. First Aid/CPR reviewed and in compliance. LAPs observed CPR to expire on 03/2021 for the three staff files reviewed. A file review was conducted for five of the school age files. LPAs observed the files to be kept according to title 22 regulations. Three of the staff records were reviewed during today's inspection. Report Continues on 809-C

SUPERVISOR'S NAME: Sharon Ogbodo	TELEPHONE: (916) 263-5721
LICENSING EVALUATOR NAME: Christopher Jackson	TELEPHONE: (916) 216-8837
LICENSING EVALUATOR SIGNATURE:	DATE: 01/17/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2020

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: COUNTRY KIDS CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 393601775
	VISIT DATE: 01/17/2020

NARRATIVE

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This facility provides Incidental Medical Services- IMS. LPAs 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.

LPAs discussed the new Mandated Reporter Training with licensee and the requirement for staff to complete the training every two years. The OCAP modules are free of cost and available at: http://www.mandatedreporterca.com/. The training is currently provided in English. LPAs observed the completion certificate in the staff files reviewed during today's inspection.

LPAs checked facilities fees and confirmed that it is up to date.

LPAs provided the Community Care Licensing website www.ccld.ca.gov, so the licensee can obtain updated licensing information, new regulations and access forms. LPAs advised licensee of their responsibility to stay current in regards to new regulations. In addition LPAs provided a copy of the "Effects of Lead Exposure" to licensee during today's inspection. LPAs also included the email address for the children's advocacy program to stay current on new laws childcareadvocatesprogram@dss.ca.gov.

No Title 22 Deficiencies observed in the areas that were evaluated. LPAs reviewed report with the director and provided copies. An exist interview was conducted. LPAs observed the Notice of Site Visit posted and the director understands it must remain posted for 30 days.

SUPERVISOR'S NAME: Sharon Ogbodo	TELEPHONE: (916) 263-5721
LICENSING EVALUATOR NAME: Christopher Jackson	TELEPHONE: (916) 216-8837
LICENSING EVALUATOR SIGNATURE:	DATE: 01/17/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2020

LIC809 (FAS) - (06/04)

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