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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 493007243
Report Date: 06/26/2019
Date Signed: 06/26/2019 11:10:20 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA
FACILITY NAME:LITTLE ANGELS CHILDREN'S CENTERFACILITY NUMBER:
493007243
ADMINISTRATOR:TAMBLIN, KRISTINFACILITY TYPE:
850
ADDRESS:4305 HOEN AVENUETELEPHONE:
(707) 579-4305
CITY:SANTA ROSASTATE: CAZIP CODE:
95405
CAPACITY:36CENSUS: 26DATE:
06/26/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Jaime DemarestTIME COMPLETED:
11:15 AM
NARRATIVE
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An unannounced inspection was made to the facility by Licensing Program Analyst (LPA), J. Velasco. The facility file was reviewed prior to this inspection. 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. LPA met with director Kristin Tamblin (D1).

The facility’s operating hours are 7:00 a.m. - 6:00 p.m., Monday-Friday, year-round. The facility was toured inside and outside, and the floor and yard plans 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 in key locked cupboards in the off-limits kitchen. D1 stated there are no poisons in the facility, and none were observed during this 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 by use of pitchers and individual water cups, both on the playground and in the classroom.

The children's bathroom is 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. LPA observed a working carbon monoxide detector in the facility. The fully fenced playground was observed to be free of hazards.

Continued on LIC 809-C
SUPERVISOR'S NAME: Alexis HollonTELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Jennifer VelascoTELEPHONE: (707) 588-5044
LICENSING EVALUATOR SIGNATURE:

DATE: 06/26/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA
FACILITY NAME: LITTLE ANGELS CHILDREN'S CENTER
FACILITY NUMBER: 493007243
VISIT DATE: 06/26/2019
NARRATIVE
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Continued from LIC 809

The playground equipment and surface areas were observed to be in safe condition. There is wood chip cushioning underneath climbing structures and/or play equipment to absorb falls. There were no bodies of water observed on the site. Staff stated no weapons are stored on site, and none were observed. During today's inspection, staffing ratios were being met, and 26 children were being supervised by three staff. The facility was operating within the licensed capacity. At least one staff member present during the inspection possessed current CPR and First Aid certifications, which expire in 02/2020. Eight children’s records were reviewed at 8:30 a.m. and contained signed admission agreements and immunization records or medical exemptions as required. Three staff records were reviewed at 9:00 a.m. and contained documentation of education and training as required.

This facility is not currently providing Incidental Medical Services (IMS). The Department’s IMS policy was discussed with D1. There will be a Plan of Operation on file with the Department if/when facility enrolls children with IMS needs. 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 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 and The Effects of Lead Exposure brochures, were reviewed and discussed with D1. 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.
The following violation(s) of the California Code of Regulations, Title 22; Division 12, were observed: see LIC 809D. Appeal Rights were provided.
SUPERVISOR'S NAME: Alexis HollonTELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Jennifer VelascoTELEPHONE: (707) 588-5044
LICENSING EVALUATOR SIGNATURE:

DATE: 06/26/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2019
LIC809 (FAS) - (06/04)
Page: 3 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA

FACILITY NAME: LITTLE ANGELS CHILDREN'S CENTER
FACILITY NUMBER: 493007243
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/26/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/15/2019
Section Cited
HSC
1596.7995(a)(1)
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Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. This requirement is not met as evidenced by:
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Director said she and all staff will either obtain medical records or get the Titer blood test to prove their immunity against measles and pertussis. Director said she will submit documentation of staff immunizations against measles and pertussis to LPA by 07/15/2019 via mail, email or fax.
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On 06/26/2019 at 9:00 a.m., LPA reviewed staff records and observed D1, S1, and S2 do not have proof of immunity against measles or pertussis. This poses a potential risk to the children in care.
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LPA Email:
jennifer.velasco@dss.ca.gov
Fax:
707-588-5099
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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: Alexis HollonTELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Jennifer VelascoTELEPHONE: (707) 588-5044
LICENSING EVALUATOR SIGNATURE:

DATE: 06/26/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2019
LIC809 (FAS) - (06/04)
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