451376264-12-3-2019-13-CC-CWIT-BJHQDZ-20191203110532

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 451376264
Report Date: 12/03/2019
Date Signed: 12/03/2019 11:05:47 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME:	MISTLETOE STATE PRESCHOOL		FACILITY NUMBER:	451376264
ADMINISTRATOR:	GROVES, BRANDY		FACILITY TYPE:	850
ADDRESS:	1225 MISTLETOE LANE		TELEPHONE:	(530) 224-3232
CITY:	REDDING	STATE: CA	ZIP CODE:	96002
CAPACITY:	24	CENSUS: 22	DATE:	12/03/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	08:00 AM
MET WITH:	Lindene Kirkwood		TIME COMPLETED:	10:40 AM

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	An annual inspection was made to the facility by Licensing Program Analyst, Wisehart. The facility file was reviewed prior to this inspection. A review of the personnel report on 12./3/19 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. This program is operated by the Shasta County Office of Education and is a Title 5 funded program. The facility is located on the Mistletoe Elementary School campus in room #106. Operating hours are 8 - 11:00 am and 12 - 3:00 pm, Monday-Friday. The facility was toured inside and outside and the floor and yard plan submitted by the licensee were verified. The items which could pose a danger to children (such as detergents, cleaning compounds and medications) were observed to be inaccessible to children. Poisons are not on preschool site but held in janitors closest on main campus. The Last Fire Drill was conducted on 11/15/19. The facility was free of flies, insects and rodents. The toys, floors, desks and other equipment and surfaces were clean, toxic free, safe and in good condition. There is uncontaminated drinking water available to children both indoors and outdoors via drinking fountains. The children’s bathrooms were in safe and sanitary condition. A current menu was posted on parent board near front door and in main class room by water fountain. Food prep areas are clean. Food is properly stored and free of contamination. Garbage cans containing solid waste have tight fitting lids.

SUPERVISOR'S NAME: Megan Aviles	TELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Carrie Wisehart	TELEPHONE: (530) 895-5824
LICENSING EVALUATOR SIGNATURE:	DATE: 12/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2019

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 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, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME: MISTLETOE STATE PRESCHOOL	FACILITY NUMBER: 451376264
	VISIT DATE: 12/03/2019

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

The playground was free of hazards. The playground equipment and surface areas were in safe condition. There is recycle rubber chip cushioning underneath climbing structures and/or play equipment to absorb falls. There were no bodies of water observed. The Lead Teacher stated no weapons are stored on site and none were observed. During today's inspection, staffing ratios were being met and there were 22 children were being supervised by 3 teachers/aides. The facility was operating within the licensed capacity. All three staff members present during the visit (S1-S3) possessed current CPR and First Aid certifications. Twelve children’s records were reviewed at 8:34 am, and contained identification forms with authorized representative information, as well as medical assessments, with the exception of Child (C1) who did not have a health screening on file. Three staff records were reviewed at 8:51 am, and contained Mandated Reporter Training. The sign in/out procedure was reviewed and in compliance. This facility is not providing Incidental Medical Services (IMS) to children. The Department’s IMS policy was discussed with the Lead Teacher. (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 Child Care Centers Sections 101173 and 101226.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: www.ada.gov/childqanda.htm. This report, as well as the AAP Guide to Safe Sleep Practices brochure, were reviewed and discussed with the Lead Teacher. All licensing reports are public information and must be made available upon request for at least three years.

Notice of Site Visit shall be posted for 30 days from today's visit.

The following violation(s) of the California Code of Regulations, Title 22; Division 12, were observed: see LIC 809D. Appeal Rights were provided.

SUPERVISOR'S NAME: Megan Aviles	TELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Carrie Wisehart	TELEPHONE: (530) 895-5824
LICENSING EVALUATOR SIGNATURE:	DATE: 12/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2019

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, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME: MISTLETOE STATE PRESCHOOL	FACILITY NUMBER: 451376264
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 12/03/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 12/31/2019 Section Cited	1 2 3 4 5 6 7	Medial Assessments 101220 - Prior to, or within 30 calendar days following the enrollment of a child, the licensee shall obtain a written medical assessment of the child. This medical assessment enables the licensee to assess whether the center can provide necessary health related services to the child.
	8 9 10 11 12 13 14	This requirement was not met as evidenced by: Based on record review of Child (C1)'s file at 8:34 am no medical assessment was on file though enrollment papers were signed in May 2019 and school started 8/14/19. This poses a potential risk to children in care. ”	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: Megan Aviles	TELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Carrie Wisehart	TELEPHONE: (530) 895-5824
LICENSING EVALUATOR SIGNATURE:	DATE: 12/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2019

LIC809 (FAS) - (06/04)

Page: 3 of 3