483001098-4-29-2019-13-CC-KMAS-BBPQB7-20190429120105

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 483001098
Report Date: 04/29/2019
Date Signed: 04/29/2019 12:01:11 PM

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:	HEAD START - PADAN		FACILITY NUMBER:	483001098
ADMINISTRATOR:	LATOYA LUMSEY		FACILITY TYPE:	850
ADDRESS:	100 PADAN SCHOOL ROAD		TELEPHONE:	(707) 446-0595
CITY:	VACAVILLE	STATE: CA	ZIP CODE:	95687
CAPACITY:	20	CENSUS:	DATE:	04/29/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	10:35 AM
MET WITH:	Maria Ayon, Family Advocate		TIME COMPLETED:	12:15 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	An annual/random inspection was made to the facility by Licensing Program Analyst (LPA), Kirk Marks. The facility file was reviewed prior to this visit. A review of the personnel report on file indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances. This is a Head Start program operated by Child Start, Inc. The facility’s operating hours are 8:00 am - 11:30 am and 1:00 pm - 4:30 pm, Monday -Thursday. 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. There are no poisons stored on site and none were observed during today's inspection. The facility was free of flies, insects and rodents. The toys, floors, desks and other equipment and surfaces are clean, toxic free, safe and in good condition. There is uncontaminated drinking water available to children both indoors and outdoors in a drinking fountain near the entrance to the school. The children's bathrooms are in safe and sanitary condition. A current menu was posted on the wall by the sign in/sign out area. Food prep areas are clean. Food is properly stored and refrigerated as needed. Garbage cans containing solid waste have tight fitting lids. The playground was free of hazards. The playground equipment and surface areas are in safe condition. There is rubber padding cushioning underneath climbing structures and/or play equipment to absorb falls. There were no bodies of water observed. The Family Advocate stated no weapons are stored on site and none were observed. During today's inspection, staffing ratios were being met and twelve children were being supervised by three teachers/aides. The facility was operating within the licensed capacity. (continued on page 2)

SUPERVISOR'S NAME: Megan Aviles	TELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Kirk Marks	TELEPHONE: (530) 895-5045
LICENSING EVALUATOR SIGNATURE:	DATE: 04/29/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2019

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

FACILITY NAME: HEAD START - PADAN	FACILITY NUMBER: 483001098
	VISIT DATE: 04/29/2019

NARRATIVE

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(continued from page 1)

At least one staff member present during the visit (S2) possessed current CPR and First Aid certifications. Ten children’s records were reviewed at 11:00, and contained identification forms with authorized representative information. Four staff records were reviewed at 11:25, and contained documentation of education and training, as required. This facility is providing Incidental Medical Services (IMS). The Department’s Incidental Medical Services (IMS) policy was discussed with the Licensee/Director. 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 was reviewed and discussed with the Family Advocate. 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.

There were no Title 22 deficiencies cited during today's inspection.

SUPERVISOR'S NAME: Megan Aviles	TELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Kirk Marks	TELEPHONE: (530) 895-5045
LICENSING EVALUATOR SIGNATURE:	DATE: 04/29/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2019

LIC809 (FAS) - (06/04)

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