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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 573601046
Report Date: 08/28/2019
Date Signed: 08/28/2019 11:41:36 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME:WOODLAND JOINT USD-DINGLEFACILITY NUMBER:
573601046
ADMINISTRATOR:HERNANDEZ, MARLENEFACILITY TYPE:
850
ADDRESS:625 ELM STREETTELEPHONE:
(530) 662-7265
CITY:WOODLANDSTATE: CAZIP CODE:
95695
CAPACITY:23CENSUS: 16DATE:
08/28/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
11:05 AM
MET WITH:Marlene Hernandez, Site SupervisorTIME COMPLETED:
12:00 PM
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Licensing Program Analysts (LPAs) Charlotte Baney and Chayntel Hunter met with Site Supervisor, Marlene Hernandez for the purpose of an unannounced Annual/Random inspection. LPAs observed care and supervision of 16 preschoolers supervised by 3 staff. LPAs toured the facility inside and out. LPAs observed that hazardous items (disinfectants, cleaning solutions etc.) were inaccessible to children in care. Facility days and hours of operation are Monday-Friday from 8:15 AM to 11:45 AM and 12:30 PM to 4:00 PM.

LPAs reviewed care and supervision of children, staffing ratios, first aid supplies, furniture, equipment, fire drills and drinking water. LPAs observed all required forms to be posted. There are adequate toys and equipment available for children. Outdoor play area was toured, the play structure appeared to be in good repair, there is sufficient cushioning (wood chips) under the play structure.

LPAs reviewed the sign in/out book and observed that the children are properly signed in/out. LPAs observed health screening reports with TB test and required MMR and TDAP vaccines. At least one staff member present today has current Pediatric CPR and First Aid. LPAs observed AB1207 mandated reporter training certificates for all staff. The Director was reminded to renew the course every 2 years through www.mandatedreporterca.com website.

Incidental Medical Services (IMS) policy was discussed. Facility does not have any children that require an IMS plan.

This facility evaluation report was reviewed and discussed with the Site Supervisor . An exit interview was conducted. A Notice of Site Visit was provided and should remain posted for a period of 30 days for parental review.

In the areas that were evaluated, no deficiencies were cited during the inspection.

SUPERVISOR'S NAME: Sharon OgbodoTELEPHONE: (916) 263-5721
LICENSING EVALUATOR NAME: Chayntel HunterTELEPHONE: (916) 917-8620
LICENSING EVALUATOR SIGNATURE:

DATE: 08/28/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2019
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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