393619989-12-5-2019-53-CC-ASRN-BJL3HM-20191205171611

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 393619989
Report Date: 12/05/2019
Date Signed: 12/05/2019 05:16:30 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:	HARVEST PRESCHOOL AND CHILD CARE		FACILITY NUMBER:	393619989
ADMINISTRATOR:	CHRISTINA HINE		FACILITY TYPE:	850
ADDRESS:	10088 N HWY 99		TELEPHONE:	(209) 751-4451
CITY:	STOCKTON	STATE: CA	ZIP CODE:	95212
CAPACITY:	40	CENSUS: 34	DATE:	12/05/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	01:38 PM
MET WITH:	Christina HIne		TIME COMPLETED:	05:15 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	At 1:45pm Licensing Program Analyst (LPA) Aruna Sridharan met with Christina Hine for the purpose of an unannounced annual inspection. Today’s census was 34 children and four staff members who have been fingerprint cleared through Community Care Licensing LPA toured the building including all activity and classroom spaces, restrooms, food service, and outdoor play areas. LPA observed appropriate ratios, care and supervision, and capacity during the visit. The hours of operation are Monday through Friday 6:30am to 6:00pm. Medications, disinfectants, cleaning solutions, and hazardous items were appropriately stored and inaccessible to children. First Aid was centrally located but inaccessible to children. Furniture, equipment, and play materials were in good condition. Playground equipment was free of loose and sharp parts. The areas under and around playground climbing equipment were cushioned with wood chips to absorb falls. The Director stated there are no firearms or bodies of water on the property. There are 3 toilets and 3 sinks. Toileting facilities were in operating, safe, and sanitary condition. Children bring their own lunch and am/pm snacks are provided by the facility. Uncontaminated drinking water is readily available to children both indoors and outdoors. LPA observed Sign In/Out Sheet with signatures, times, and dates. LPA reviewed 8 children’s files and observed that each child had their Identification/Emergency Information and the Consent for Medical Treatment form filled out and signed by their authorized representative. Report continues on 809C......

SUPERVISOR'S NAME: Sharon Ogbodo	TELEPHONE: (916) 263-5721
LICENSING EVALUATOR NAME: Aruna Sridharan	TELEPHONE: (916) 917-9273
LICENSING EVALUATOR SIGNATURE:	DATE: 12/05/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2019

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: HARVEST PRESCHOOL AND CHILD CARE	FACILITY NUMBER: 393619989
	VISIT DATE: 12/05/2019

NARRATIVE

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At least one staff member present today had current Pediatric CPR and First Aid certification (expires 07/20). All staff currently employed with the facility have criminal record clearances. LPA also reviewed documentation of qualifications including education and experience. LPA discussed the Departmental inspection authority, and also informed the Licensee that any changes regarding the Center Director or their Designee must be reported to Department within 10 working days.

LPA also discussed Unusual Incident Reports (UIRs) and reporting requirements. LPA informed the Director that if any unusual incidents occur she must contact the Department within 24 hours and an UIR must be submitted with 7 day, describing the specifics to the incident.

LPA discussed the new Immunization Regulations SB 792, the requirement that all individuals working or volunteering at a licensed Child Care facility must have vaccinations. The staff did not have documentation of proof of immunizations.

LPA provided the Community Care Licensing’s website www.ccld.ca.gov, so the licensee can obtain updated licensing information, new regulations and access forms. LPA advised the licensee of their responsibility to stay current in regards to new regulations.

LPA advised the licensee on the new regulation AB 1207- California Child Care Worker: Mandated Reporter Training. The licensee must complete the training every two years starting January 1, 2018 and retain proof of completion in the facility file. The training can be found at: mandatedreporterca.com. Some staff members need to take the Chilcare Providers rather than Educators Training.

Report continues on 809C.........

SUPERVISOR'S NAME: Sharon Ogbodo	TELEPHONE: (916) 263-5721
LICENSING EVALUATOR NAME: Aruna Sridharan	TELEPHONE: (916) 917-9273
LICENSING EVALUATOR SIGNATURE:	DATE: 12/05/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2019

LIC809 (FAS) - (06/04)

Page: 2 of 4

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: HARVEST PRESCHOOL AND CHILD CARE	FACILITY NUMBER: 393619989
	VISIT DATE: 12/05/2019

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LPA discussed the Incidental Medical Services (IMS) policies with the licensee. The facility is currently not providing IMS. LPA discussed the IMS policy. For IMS information see the Evaluator Manual Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and Medication Regulations 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), 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 observed in the areas that were evaluated are on page 809D. LPA reviewed report and provided copies to the facility. An exit interview was conducted. Appeal Rights were provided and Notice of Site posted and the Director understands it must remain posted for 30 days.

SUPERVISOR'S NAME: Sharon Ogbodo	TELEPHONE: (916) 263-5721
LICENSING EVALUATOR NAME: Aruna Sridharan	TELEPHONE: (916) 917-9273
LICENSING EVALUATOR SIGNATURE:	DATE: 12/05/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2019

LIC809 (FAS) - (06/04)

Page: 3 of 4

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: HARVEST PRESCHOOL AND CHILD CARE	FACILITY NUMBER: 393619989
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 12/05/2019

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	The day care center shall maintain documentation of the required immunizations.....personnel record that is maintained by the day care center. This was not evidenced based;
	8 9 10 11 12 13 14	LPA reviewed all the staff files and the licensee did not have documentation of proof of immunizations for staff.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7
	1 2 3 4 5 6 7

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: Sharon Ogbodo	TELEPHONE: (916) 263-5721
LICENSING EVALUATOR NAME: Aruna Sridharan	TELEPHONE: (916) 917-9273
LICENSING EVALUATOR SIGNATURE:	DATE: 12/05/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2019

LIC809 (FAS) - (06/04)

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