490107330-7-12-2019-01-CC-ASTR-BDZSBR-20190712134423

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 490107330
Report Date: 07/12/2019
Date Signed: 07/12/2019 02:39:01 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928

FACILITY NAME:	CHILDKIND PRESCHOOL		FACILITY NUMBER:	490107330
ADMINISTRATOR:	MC INTYRE, AMY		FACILITY TYPE:	850
ADDRESS:	2200 LAGUNA ROAD		TELEPHONE:	(707) 823-6993
CITY:	SANTA ROSA	STATE: CA	ZIP CODE:	95401
CAPACITY:	24	CENSUS: 11	DATE:	07/12/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	11:05 AM
MET WITH:	Apphrodite Bellochio		TIME COMPLETED:	02:15 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), Amy Strother. 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 or exemptions. The facility’s operating hours are 7:00 a.m. - 6:00 p.m., 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. The director stated that there are no poisons stored on the premises and none were observed during today's inspection. 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 provided by individually labelled water bottles filled with filtered water. The children's bathrooms are in safe and sanitary condition. Food prep areas are clean. Food is properly stored and refrigerated as needed. There was no contaminated food observed. Garbage cans containing solid waste have tight fitting lids. The LPA observed a working carbon monoxide detector in the facility. The playground was free of hazards. The playground equipment and surface areas were in safe condition. There is wood chip cushioning underneath climbing structures and/or play equipment to absorb falls. LPA Strother suggested to the director to move some of the wood chips from the corners of the yard to the areas under the slide and climbing wall on the climber to better cushion those areas. There were no bodies of water observed. The director stated there are no weapons stored on site and none were observed. During today's inspection, staffing ratios were being met, and 11 children were being supervised by 2 teachers/aides. The facility was operating within the licensed capacity. At least one staff member present during the visit (S1) possessed current CPR and First Aid certifications. The sign-in/sign-out procedure was reviewed and in compliance. Six children’s records were reviewed at 11:25 a.m., and contained signed admission agreements as well as all of the required documents. Continue on LIC809-C

SUPERVISOR'S NAME: Alexis Hollon	TELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Amy Strother	TELEPHONE: (707) 588-5077
LICENSING EVALUATOR SIGNATURE:	DATE: 07/12/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2019

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, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928

FACILITY NAME: CHILDKIND PRESCHOOL	FACILITY NUMBER: 490107330
	VISIT DATE: 07/12/2019

NARRATIVE

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Three staff records were reviewed at 11:45 a.m. and contained documentation of education and training as required, as well as all of the required documents. LPA requested that the director submit to the department a copy of the most current LIC500 (Personnel Report) and LIC610 (Emergency Disaster Plan). LPA also requested that the director add to the admission agreement or post in the center, a statement regarding payment provisions, specifically the basic rate. This facility is not providing Incidental Medical Services (IMS) at this time. The director stated that none of the children currently enrolled require IMS. The Department’s IMS policy was discussed with the Director. LPA went over the list of requirements to be included in a plan of operation for providing IMS. The director stated that she may create a plan of operation for providing IMS before the need for one comes up. LPA stated that the director may request assistance from the LPA if needed. 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,The Effects of Lead Exposure brochures, and the Community Care Licensing website were reviewed and discussed with the director. 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: Alexis Hollon	TELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Amy Strother	TELEPHONE: (707) 588-5077
LICENSING EVALUATOR SIGNATURE:	DATE: 07/12/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2019

LIC809 (FAS) - (06/04)

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