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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 493004286
Report Date: 03/03/2022
Date Signed: 03/03/2022 04:30:28 PM


Document Has Been Signed on 03/03/2022 04:30 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405



FACILITY NAME:LITTLE ONES BACKYARD CLUB - PRESCHOOLFACILITY NUMBER:
493004286
ADMINISTRATOR:DEAS, DEBBIEFACILITY TYPE:
850
ADDRESS:399 COLLEGE VIEW DRIVETELEPHONE:
(707) 792-1620
CITY:ROHNERT PARKSTATE: CAZIP CODE:
94928
CAPACITY:39CENSUS: 10DATE:
03/03/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:02 PM
MET WITH:Debbie DeasTIME COMPLETED:
03:16 PM
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An annual required inspection was made to the facility by Licensing Program Analyst (LPA), Y. Yang. The facility file was reviewed prior to this inspection. A review of the personnel report on 03/03/22 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 center director was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

The LPA met with the facility's licensee Debbie Deas today. The facility’s operating hours are 06:30am-06:00pm, Monday – Friday. This is a combination center with a school age license. The facility was toured inside and outside and the floor and yard plan submitted by the licensee were verified. The toys, floors, desks and other equipment and surfaces were clean, toxic free, safe and in good condition. The facility was free of flies, insects and rodents. There is drinking water available to children both indoors in the classrooms and outdoors on the playground. The children’s bathrooms were in safe and sanitary condition. A snack menu was posted by the center's main entrance. Food prep areas are clean. Food is properly stored and free of contamination. AM and PM snacks are provided by the center. The children bring lunches from home. Garbage cans containing solid waste were in good repair and had tight fitting lids. The playground was free of hazards. There is wood chip cushioning in the playground underneath climbing structures. There were no bodies of water observed. The center director stated no weapons or poisons are stored on site. During today's inspection, staffing ratios were being met and there were 10 children being supervised by 3 teachers. The facility was operating within the licensed capacity.The sign in/out sheet was reviewed and was in compliance with regulations. Eight children’s records were reviewed at 12:47pm, and contained identification forms with authorized representative information, as well as medical assessment forms. Four staff files were reviewed at 11:25am; the LPA observed that staff S1-S4 did not possess a current California Child Abuse Mandated Reporter training certificate. Furthermore, there was not a staff member present at the center that possessed a current pediatric first aid/CPR certificate. Continued on LIC 809-C
SUPERVISOR'S NAME: Alexis HollonTELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Yang YangTELEPHONE: 707-588-5026
LICENSING EVALUATOR SIGNATURE:
DATE: 03/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/03/2022
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, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: LITTLE ONES BACKYARD CLUB - PRESCHOOL
FACILITY NUMBER: 493004286
VISIT DATE: 03/03/2022
NARRATIVE
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Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee, Debbie Deas. The following violation(s) of the California Code of Regulations, Title 22; Division 12, were observed: see LIC 809D. Appeal Rights were provided.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process

SUPERVISOR'S NAME: Alexis HollonTELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Yang YangTELEPHONE: 707-588-5026
LICENSING EVALUATOR SIGNATURE:

DATE: 03/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2022
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 03/03/2022 04:30 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405


FACILITY NAME: LITTLE ONES BACKYARD CLUB - PRESCHOOL

FACILITY NUMBER: 493004286

DEFICIENCY INFORMATION FOR THIS PAGE:

VISIT DATE: 03/03/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on the LPA's staff record review at 11:25am, the licensee did not comply with the section cited above in 1596.8662(b)(1) and ensure that staff member S1-S4 had a current California Child Abuse Mandated Reporter training certificate pursuant to AB1207. This poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/17/2022
Plan of Correction
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The licensee stated that staff S1-S4 will complete the online California Child Abuse Mandated Reporter training and submit proof of completion to CCLD by 03/17/22. The training can be found at mandatedreporterca.com
Type B
Section Cited
CCR
101216(f)
Personnel Requirements
(f) At least one staff member who is trained in pediatric cardiopulmonary resuscitation and pediatric first aid pursuant to Health and Safety Code Section 1596.866 shall be present when children are at the child care center or offsite for center activities.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on the LPA's staff record review at 11:25am, the licensee did not comply with the section cited above in 101216(f) and ensure that at least one staff member present today posessed a current peidatric first aid/CPR certificate.This poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/07/2022
Plan of Correction
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The licensee stated that she will complete an EMSA approved pediatric CPR/first aid course and submit proof of completion of training to CCLD by 04/07/22.

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: Alexis HollonTELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Yang YangTELEPHONE: 707-588-5026
LICENSING EVALUATOR SIGNATURE:
DATE: 03/03/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/03/2022
LIC809 (FAS) - (06/04)
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