485407766-9-22-2020-13-CC-CWIT-BTPNU8-20200922104552

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 485407766
Report Date: 09/14/2020
Date Signed: 09/22/2020 10:45:58 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:	FAIRMONT PRESCHOOL		FACILITY NUMBER:	485407766
ADMINISTRATOR:	MOFFITT, GREG		FACILITY TYPE:	850
ADDRESS:	1355 MARSHALL DRIVE		TELEPHONE:	(707) 453-7212
CITY:	VACAVILLE	STATE: CA	ZIP CODE:	95687
CAPACITY:	44	CENSUS:	DATE:	09/14/2020
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Lauren Hylton		TIME COMPLETED:	10:50 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	The facility pre-licensing inspection was conducted via tele-inspection due to the current state of emergency regarding the COVID-19 outbreak by Licensing Program Analyst (LPA), Wisehart. The applicant has applied for a capacity of 44 preschool age children. The facility was toured inside and outside. The center will operate from 8:30 am- 11:30 am and 12:15 pm - 3:15 pm, M-F. The preschool facility consists of 2 classroom(s) serving ages 2 to 5 years old. The fire clearance was approved (8/11/20) for 44 preschoolers. The indoor capacity measured for 35 children and the outdoor yard area measured for 30 children. Therefore, the 44 requested capacity is denied and approved for 35 children inside. A shared playground waiver is pending approval for 30 children. Required postings (Parents Personal Rights, Emergency Disaster Plan, Earthquake Preparedness Checklist, Menu, etc.) listed on Form LIC 311A are posted. The applicant was advised that all staff are required to have a criminal background clearance on file with Community Care Licensing. The applicant is aware of the immediate $100 per day civil penalty for anyone providing care or supervision without a criminal record clearance. The facility has a qualified Director on site. Sign-In/Out procedures were reviewed. The applicant/director understands that if a manual Sign-In/Out procedure is used, full legal signatures are required. Cubbies are available for children to use. There are pull fire alarms, and there is a working carbon monoxide detector and charged fire extinguisher in the facility rated at least the 2A10BC. All Exits are marked. There is 4 bathrooms with 4 toilets and 8 sinks for children's use. There are two staff bathrooms, which are separate. There are 4 indoor drinking fountains available and one outdoor drinking fountain, and children will also use bottled water in the play area. Children will use the fenced outdoor play area. The isolation area for a sick child will be established in the Speech Therapist Office/Nurse Office, an a mat will be provided. The facility is a half day program therefore, napping does not occur at the program. Lunch is provided at the end of the morning program and being of afternoon program. Continued

SUPERVISOR'S NAME: Megan Aviles	TELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Carrie Wisehart	TELEPHONE: (530) 895-5824
LICENSING EVALUATOR SIGNATURE:	DATE: 09/14/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2020

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

FACILITY NAME: FAIRMONT PRESCHOOL	FACILITY NUMBER: 485407766
	VISIT DATE: 09/14/2020

NARRATIVE

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(Continued from LIC 809)

The food is properly stored and refrigeration is provided. Age appropriate toys and activities are available for children. There is artificial turf cushion material and sand in the play yard area. No climbing structures were observed at time of visit. There are canopies and pergola present to provide shade in the play yard. There are no bodies of water located on the property and none are to be added without prior notification and approval of the licensing agency. Incidental Medical Services (IMS) policy was discussed. 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. This report, as well as the Guide to Safe Sleep Practices brochure and Lead Exposure Testing Flyer, were reviewed and discussed with the applicant/director. All licensing reports are public information and must be made available upon request for at least three years.

Any proposed changes to the physical plant, telephone number, or change of address shall be immediately reported to the Department.

SUPERVISOR'S NAME: Megan Aviles	TELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Carrie Wisehart	TELEPHONE: (530) 895-5824
LICENSING EVALUATOR SIGNATURE:	DATE: 09/14/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2020

LIC809 (FAS) - (06/04)

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