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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 515407056
Report Date: 08/02/2019
Date Signed: 08/02/2019 03:13:05 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME:KIDZ TIME SCHOOL AGE CENTERFACILITY NUMBER:
515407056
ADMINISTRATOR:HOWARD, PATFACILITY TYPE:
840
ADDRESS:369 HARDING ROADTELEPHONE:
(530) 673-7645
CITY:YUBA CITYSTATE: CAZIP CODE:
95993
CAPACITY:45CENSUS: 25DATE:
08/02/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Pat HowardTIME COMPLETED:
03:25 PM
NARRATIVE
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A inspection was made to the facility by Licensing Program Analyst (LPA) Martinez and Wisehart. The facility file was reviewed prior to this visit. Upon entering the facility at 1:05PM LPA's observed a few children playing in the breezeway of the entrance. Upon further walking in LPA's observed one staff member sweeping while 25 children were playing. LPA's requested to speak to the Director who appeared from the kitchen area, thus making the facility in ratio. The facility was operating within the licensed capacity. 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 6:30-6:30, Monday-Friday June through August. 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 and cleaning compounds) were observed to be accessible to children in care in the kitchen that is used for snack time and lunch. During today's visit at 1:15PM LPA's observed Windex, 409, Comet and Simple Green that were accessible to children. The facility was free of flies, insects and rodents. 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 water cooler. The children's bathrooms are in safe and sanitary condition. Food prep areas are clean. Food is provided by the YCUSD however children have the option to bring their own food. Food is properly stored and refrigerated as needed. The playground was free of hazards. The playground equipment and surface areas are in safe condition.
SUPERVISOR'S NAME: Erin VirruetaTELEPHONE: (530) 895-4325
LICENSING EVALUATOR NAME: Mikah MartinezTELEPHONE: (530) 895-4014
LICENSING EVALUATOR SIGNATURE:

DATE: 08/02/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/02/2019
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 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME: KIDZ TIME SCHOOL AGE CENTER
FACILITY NUMBER: 515407056
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/02/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/09/2019
Section Cited
CCR
101516.5(b)
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There shall be a staffing ratio of one teacher and one aide present to every 28 children in attendance. This requirement is not met as evidenced by; based on observations LPA's entered the facility to observe one staff member with 25 children while the director stepped into the kitchen. This is a potential health and safety risk to children in care.
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During the visit the Director did come back to the outside area and provided extra coverage. The director agrees to review the staffing ratio for school age children and discuss with staff. The director shall send in documentation of the reviewed staffing ratio no later than 8/9/19.
Type B
08/09/2019
Section Cited
CCR
101238(g)
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Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children shall be stored where inaccessible to children. This requirement is not met as evidenced by; based on observations the Director failed to keep windex, comet, 409 and simple green inaccessible to children. This is a
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During today's visit the Director moved the poisons to a key locked janitorial closet. The citation has been cleared.
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potential health and safety risk to children in care.
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Type B
08/09/2019
Section Cited
CCR
1596.8662(b)(1)
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On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training. This requirement is not met as evidenced by; based on record review the Director failed to have all staff providing care and supervision complete the course
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This is a potential health and safety risk to children in care. The director agrees to have all staff complete the mandated reporter training course and send into CCL no later than 8/9/19.
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: Erin VirruetaTELEPHONE: (530) 895-4325
LICENSING EVALUATOR NAME: Mikah MartinezTELEPHONE: (530) 895-4014
LICENSING EVALUATOR SIGNATURE:

DATE: 08/02/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/02/2019
LIC809 (FAS) - (06/04)
Page: 3 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME: KIDZ TIME SCHOOL AGE CENTER
FACILITY NUMBER: 515407056
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/02/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/09/2019
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. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year. This requirement is not met as evidenced by; Based
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The director agrees to have staff provide records of immunization of MMR/Tdap/ and Flu no later than 8/9/19 for staff S1/S2/S3.
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on record review the Director failed to maintain records of facility immunization for staff providing care and supervision. This is a potential health and safety risk to children 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: Erin VirruetaTELEPHONE: (530) 895-4325
LICENSING EVALUATOR NAME: Mikah MartinezTELEPHONE: (530) 895-4014
LICENSING EVALUATOR SIGNATURE:

DATE: 08/02/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/02/2019
LIC809 (FAS) - (06/04)
Page: 4 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME: KIDZ TIME SCHOOL AGE CENTER
FACILITY NUMBER: 515407056
VISIT DATE: 08/02/2019
NARRATIVE
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There is sand and grass cushioning underneath climbing structures and/or play equipment to absorb falls. There were no bodies of water observed. The Director stated no weapons are stored on site and none were observed. At least one staff member present during the visit (S1) possessed current CPR and First Aid certifications. Ten children’s records were reviewed at 2:00PM, and contained identification forms with authorized representative information. Three staff records were reviewed at 1:55PM, and contained documentation of education, as required. This facility is providing Incidental Medical Services (IMS). The Department’s Incidental Medical Services (IMS) policy was discussed with the Licensee/Director. 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 brochure, 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.

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: Erin VirruetaTELEPHONE: (530) 895-4325
LICENSING EVALUATOR NAME: Mikah MartinezTELEPHONE: (530) 895-4014
LICENSING EVALUATOR SIGNATURE:

DATE: 08/02/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/02/2019
LIC809 (FAS) - (06/04)
Page: 2 of 4