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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 573601192
Report Date: 08/28/2019
Date Signed: 08/28/2019 04:59:22 PM

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 MIGRANT HEAD START-INFFACILITY NUMBER:
573601192
ADMINISTRATOR:LOPEZ, LIDIAFACILITY TYPE:
830
ADDRESS:39839 ROAD 17ATELEPHONE:
(530) 666-6452
CITY:WOODLANDSTATE: CAZIP CODE:
95695
CAPACITY:24CENSUS: 24DATE:
08/28/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Lidia Lopez, Center DirectorTIME COMPLETED:
05:15 PM
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Licensing Program Analysts (LPAs) Charlotte Baney and Chayntel Hunter met with Center Director, Lidia Lopez for the purpose of an unannounced Annual/Random inspection. LPAs observed care and supervision of 24 infants supervised by 11 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 5:00 AM to 5:00 PM from April until October. LPAs observed proper storage of refrigerated bottles which were dated and labeled with children's names.

LPAs reviewed care and supervision of children, staffing ratios, medications and first aid supplies, furniture, equipment, fire drills and drinking water. LPAs observed all required forms to be posted. There were cribs available for each infant under 12 months old and cots available for infants over 12 months old. There are in-service plans for each infant and toddler enrolled. LPAs observed a changing table within arm's reach of the sink. There are adequate toys and equipment available for children. Outdoor play area was toured, the play structure for the infants appeared to be in good repair, there is sufficient cushioning under the play structure to prevent injury from a fall.

LPAs reviewed the elecctronic sign in/out tablet and observed that the children are properly signed in. LPAs reviewed children’s files. All staff present during today's inspection have a fingerprint clearance. LPAs observed health screening reports with TB test and required MMR and TDAP vaccines for all staff members. LPAs observed staff members present today with current Pediatric CPR and First Aid. LPAs observed AB1207 mandated reporter training for staff. The Center Director was reminded to renew the course every 2 years through www.mandatedreporterca.com website.

Report continues on 809-C

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)
Page: 1 of 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME: WOODLAND MIGRANT HEAD START-INF
FACILITY NUMBER: 573601192
VISIT DATE: 08/28/2019
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Incidental Medical Services (IMS) policy was discussed. Facility has a plan in place. 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 facility evaluation report was reviewed and discussed with the Director. 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. The Director was encouraged to visit the Department's website at WWW.CCLD.CA.GOV for information regarding child care updates, forms, regulations and legislation pertaining child care centers.

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
LIC809 (FAS) - (06/04)
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