493008692-9-5-2019-01-CC-KOCL-BFQPXU-20190905114255

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 493008692
Report Date: 09/05/2019
Date Signed: 09/05/2019 11:43:01 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:	4CS FLOWERY PRESCHOOL		FACILITY NUMBER:	493008692
ADMINISTRATOR:	AVALOS, CLAUDIA		FACILITY TYPE:	850
ADDRESS:	17600 SONOMA HWY.		TELEPHONE:	(707) 935-6060
CITY:	SONOMA	STATE: CA	ZIP CODE:	95476
CAPACITY:	24	CENSUS: 16	DATE:	09/05/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Claudia Avalos		TIME COMPLETED:	11:57 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	A annual inspection was made to the facility by Licensing Program Analyst (LPA) Kevin O'Connell. The facility file was reviewed prior to this visit. A review of the personnel report on 9/05/19 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. This program operates Monday - Friday; 8:30 am to 12:00 pm. The facility was toured with the Director at 10:40am and the floor and yard plan submitted by the licensee were verified. This facility is licensed for 24 children. Three teachers were supervising 16 children during today's inspection and were operating within the licensed capacity and ratio requirements. 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 states that there are no poisons. 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 on the playground. The children's bathrooms are in safe and sanitary condition. Food prep areas are clean. Breakfast is served and a menu was posted. Garbage containers containing solid waste have tight fitting lids. The LPA observed a working carbon monoxide detector and there was a charged fire extinguishers of at least 2A 10: BC or larger. The playground was fenced and free of hazards. The playground equipment was in safe condition. There are wood chips for cushioning underneath the climbing structures to absorb falls. The Director stated that there are no bodies of water and none were observed. The Director stated no weapons are stored on site and none were observed. Two teachers had current Pediatric CPR and First Aid certifications on file, expiring in 4/2021.

SUPERVISOR'S NAME: Leslie Lepori	TELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Kevin O'Connell	TELEPHONE: (707) 588-5026
LICENSING EVALUATOR SIGNATURE:	DATE: 07/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2019

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,
, CA

FACILITY NAME: 4CS FLOWERY PRESCHOOL	FACILITY NUMBER: 493008692
	VISIT DATE: 09/05/2019

NARRATIVE

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The sign-in/sign-out procedure was reviewed and in compliance. Three staff records were reviewed at 10:50am for immunizations, Mandated Reporter Certificates and documentation of education and all were compliant. Eight children’s records were reviewed at 11:00am, and contained signed admission agreements.
Incidental Medical Services (IMS) policy was discussed. This facility does not provide IMS at this time. 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

This report, as well as the AAP Guide to Safe Sleep, Safe Sleep in Childcare brochure, What does a Safe Sleep Environment Look Like brochure & Safe Sleep Concepts handout, were reviewed and discussed with the Director. The Effects of Lead Exposure brochure has been reviewed with 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: Leslie Lepori	TELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Kevin O'Connell	TELEPHONE: (707) 588-5026
LICENSING EVALUATOR SIGNATURE:	DATE: 09/05/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/05/2019

LIC809 (FAS) - (06/04)

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