406212971-8-2-2022-17-CC-EBAY-CGWQPC-20220802122032

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 406212971
Report Date: 08/02/2022
Date Signed: 08/02/2022 12:20:41 PM

Document Has Been Signed on 08/02/2022 12:20 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME:	KIDZ KORNER PRESCHOOL		FACILITY NUMBER:	406212971
ADMINISTRATOR:	CAMILLE BRUNNER		FACILITY TYPE:	850
ADDRESS:	3396 JOHNSON AVE.		TELEPHONE:	(805) 544-5194
CITY:	SAN LUIS OBISPO	STATE: CA	ZIP CODE:	93401
CAPACITY:	60	CENSUS: 20	DATE:	08/02/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Camille Brunner		TIME COMPLETED:	12:30 PM

NARRATIVE

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On 8/2/22, at 9:30 AM, Licensing Program Analyst (LPA) Elvin Baddley conducted an unannounced Required Inspection the abovementioned Child Care Center (CCC). LPA met with Camille Brunner, Director of the CCC and explained the purpose of the inspection. LPA toured the interior and exterior of the CCC. The CCC operates from 7:30 AM to 5:30 PM, Monday - Friday. The CCC is on the grounds of the Church of the Nazarene in San Luis Obispo. The CCC uses three classrooms ("Jet" Room - ages 4-5, "Chopper" Room- ages 2 and 3, "Chu Chu" Room- ages 3) for care. One classroom of the CCC is currently closed. LPA observed 20 children on site along with 3 teachers (cleared and associated) providing supervision. LPA notes the Director also assist with care and supervision of the children.

All classrooms of the CCC were clean and organized. The classrooms have age appropriate toys and furnishings available for children in care. All classrooms have operable combination carbon monoxide/smoke detectors. LPA tested a combination carbon monoxide/smoke detector at 10;:20 AM. The restrooms of the CCC used from care are observed in safe and sanitary operating condition. LPA observed operable refrigerator in each classroom which contained children's lunches. The lunches in the refrigerators are labeled. LPA notes snacks are provided by the CCC, while children in care bring lunches from their homes. The CCC reminds parent to provide healthy lunches which contain the essential food groups. There is available drinking water for children both inside the classroom and outside in the play area. The Director was reminded of the requirement to have the CCC water sources tested for lead containments. LPA reviewed posted menu in the classrooms while licensing required notices and documents are posted near the entry of each classroom. LPA observed sign In/out forms in the outdoor area and found the documentation to be completed appropriately.

Disinfectants and cleaning solutions are observed in secured locations in each classroom which are inaccessible to children in care. Director notes no medication is on site, but when medication is present it is stored in a secure location. Waste receptacles with tight fitting covers are observed throughout the CCC.

(CONT. 809-C)

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Elvin Baddley	TELEPHONE: (805) 635-4697
LICENSING EVALUATOR SIGNATURE:	DATE: 08/02/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/02/2022

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, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: KIDZ KORNER PRESCHOOL	FACILITY NUMBER: 406212971
	VISIT DATE: 08/02/2022

NARRATIVE

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The CCC has two outdoor playground areas. The playground area for 2 to 3 year olds is in the courtyard of the classrooms. The playground area for older children is in south end of the CCC and enclosed by cinder block and chain link fencing. The fences' entry/exit gates are secured. LPA observed age appropriate toys and play equipment in each of the the play areas. The toys and play equipment observed are in suitable condition and free of sharp, loose or pointed objects. The play structures in the playground areas have adequate cushioning materials to absorb falls (I.e wood chips) and an abundance of shade created by trees, shade covering and building overhangs. LPA reminded Director to replace outdoor place equipment when it begin to degrade or is not in good repair. No bodies of water are observed on site.

Staff and children's records are reviewed. The children’s records were complete and found to contain emergency contact information as well as immunization records. The CCC also has documentation capturing children (ages 18-24 months) sleep checks in intervals of 15 minutes. Staff member's records were reviewed and contained current CPR and First Aid certifications and well as Mandated Reporter certifications and qualifications. LPA notes CCC record indicate the last fire drill was completed in April of 2022. Director informed LPA no firearm or ammunition is stored on site.

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

LPA discussed the safe sleep regulations with Director and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an for additional resource. LPA also informed Director of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Facility representative were reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to

(CONT. 809-C)

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Elvin Baddley	TELEPHONE: (805) 635-4697
LICENSING EVALUATOR SIGNATURE:	DATE: 08/02/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/02/2022

LIC809 (FAS) - (06/04)

Page: 2 of 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: KIDZ KORNER PRESCHOOL	FACILITY NUMBER: 406212971
	VISIT DATE: 08/02/2022

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 26 27 28 29 30 31 32	initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Facility representative Camille Brunner .

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Elvin Baddley	TELEPHONE: (805) 635-4697
LICENSING EVALUATOR SIGNATURE:	DATE: 08/02/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/02/2022

LIC809 (FAS) - (06/04)

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