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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 493002686
Report Date: 02/26/2020
Date Signed: 02/26/2020 03:23:47 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:TINY TREASURES PRESCHOOL, INC.FACILITY NUMBER:
493002686
ADMINISTRATOR:FIORI, ELIZABETHFACILITY TYPE:
850
ADDRESS:180 WIKIUP DRIVETELEPHONE:
(707) 544-8469
CITY:SANTA ROSASTATE: CAZIP CODE:
95403
CAPACITY:60CENSUS: 51DATE:
02/26/2020
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Elizabeth Fiori, LicenseeTIME COMPLETED:
03:45 PM
NARRATIVE
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Licensing Program Analyst (LPA) N. Cunningham conducted an unannounced case management visit to clear the citation issued on 01/28/20. Licensee met with the Licensee and discussed the purpose of the visit. LPA observed one staff member (Staff 3) who did not have criminal record clearance. At 1:30 p.m., LPA reviewed Facility Personnel Report dated 01/27/20 which indicated Staff 3 does not currently have a criminal record clearance. Staff 3 stated she has worked at the facility since September 2019. Staff 3 e-mailed LPA a copy of the LiveScan paperwork she submitted along with her fingerprints. The LiveScan form did not include a facility number, therefore, Staff 3's fingerprints were unable to be associated to the facility. The Licensee called the company that scanned Staff 3's fingerprints and learned Staff 3 will need to get reprinted. The Licensee will send Staff 3 to get her fingerprints scanned tomorrow at 9:00 a.m. A Civil Penalty in the amount of $500 was accessed for an individual working in a facility without a fingerprint clearance. This report was reviewed and discussed with the Licensee.

The following violation(s) of the California Code of Regulations, Title 22; Division 12, were observed: see LIC 809D. Appeal rights were provided. Reports citing Type A violations are to be provided to parents/guardians of children currently enrolled and to parents/guardians of children newly enrolled at the facility during the next 12 months. Parents/guardians must sign Form LIC9224 to be kept in each child's file.
Notice of Site Visit shall be posted for 30 days from today's date.

SUPERVISOR'S NAME: Leslie LeporiTELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Nicolette CunninghamTELEPHONE: (707) 588-5056
LICENSING EVALUATOR SIGNATURE:

DATE: 02/26/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2020
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, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928

FACILITY NAME: TINY TREASURES PRESCHOOL, INC.
FACILITY NUMBER: 493002686
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/26/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Deficiency Dismissed
Type A
02/27/2020
Section Cited

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(i) Prior to employment or initial presence in the child care center, all employees and volunteers subject to a criminal record review shall: (2) Request a transfer of a criminal record clearance as specified in Section 101170(f) or
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This requirement was not met by evidence of: Today at 01:30pm, a file review indicated Staff 3 is not associated to the facility. At 1:45am, LPA interviewed Staff 3 who stated she has worked at the facility isnce September. Staff 3 e-mailed the LiveScan form she submitted with her fingerprints. The form did not indicate to associate the fingerprints to the facility number. This poses an immediate health and safety risk to children or child in care.
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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: Leslie LeporiTELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Nicolette CunninghamTELEPHONE: (707) 588-5056
LICENSING EVALUATOR SIGNATURE:
DATE: 02/26/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/26/2020
LIC809 (FAS) - (06/04)
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