573619781-3-4-2024-53-CC-LSCT-D32U2E-20240304141149

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 573619781
Report Date: 03/04/2024
Date Signed: 03/04/2024 02:11:55 PM

Document Has Been Signed on 03/04/2024 02:11 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME:	ST. LUKE'S PRESCHOOL & NURSERY SCHOOL (INF)		FACILITY NUMBER:	573619781
ADMINISTRATOR:	LAURIE MOORE		FACILITY TYPE:	830
ADDRESS:	515 SECOND STREET		TELEPHONE:	(530) 662-1853
CITY:	WOODLAND	STATE: CA	ZIP CODE:	95695
CAPACITY:	16	CENSUS: 8	DATE:	03/04/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	11:45 AM
MET WITH:	Facility Representative, Carissa Crain		TIME COMPLETED:	02:15 PM

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	Licensing Program Analysts (LPAs) Lauren Scott and Janie Davis met with facility representative, Carissa Crain for the purpose of an unannounced annual inspection. There were 8 children present during today's inspection. Currently facility does not have any toddlers enrolled.. Facility days and hours of operation are Monday-Friday from 7:30 AM to 5:30 PM. LPA reviewed the sign in/out book and observed that the children are properly signed in. Licensee was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated. LPA toured the facility inside and out. LPA observed all required forms to be posted. LPA observed that hazardous items were inaccessible to children in care. The furniture and equipment appeared to be in good condition. There are adequate toys and equipment available for children. LPA reviewed care and supervision of children, including staffing ratios. LPA observed a properly store medications and a well stocked first aid kit. LPA observed documentation that a fire drill is being conducted at least once every 6 months. LPA observed a changing table within arm's reach of the sink. Outdoor play area was toured, the play equipment appeared to be in good condition. LPA observed proper storage of refrigerated bottles which were dated and labeled with children's names. Report continues on 809-C

SUPERVISOR'S NAME: Chayntel Hunter	TELEPHONE: (916) 917-8620
LICENSING EVALUATOR NAME: Lauren Scott	TELEPHONE: (916) 926-9488
LICENSING EVALUATOR SIGNATURE:	DATE: 03/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2024

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
SACRAMENTO SOUTH, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: ST. LUKE'S PRESCHOOL & NURSERY SCHOOL (INF)	FACILITY NUMBER: 573619781
	VISIT DATE: 03/04/2024

NARRATIVE

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LPA reviewed children’s and staff files. There are needs and services plans for each infant and toddler enrolled. LPA observed health screening reports with TB test and required MMR and TDAP vaccines for all staff members. All staff members present today has current Pediatric CPR and First Aid. LPA observed AB1207 mandated reporter training for all staff. The Director was reminded to renew the course every 2 years through www.mandatedreporterca.com website.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment. In addition, LPA discussed the infant sleep regulations with licensee. LPA observed 15min infant napping logs for infants 24 months and under. LPA observed a copy of LIC 9227 Individual Sleeping Plan for infants during today's inspection, per safe sleep regulations. There were cribs available for each infant under 12 months old and cots available for infants over 12 months old.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. 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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1- CCP). LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP
Report continues on 809-C

SUPERVISOR'S NAME: Chayntel Hunter	TELEPHONE: (916) 917-8620
LICENSING EVALUATOR NAME: Lauren Scott	TELEPHONE: (916) 926-9488
LICENSING EVALUATOR SIGNATURE:	DATE: 03/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2024

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
SACRAMENTO SOUTH, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: ST. LUKE'S PRESCHOOL & NURSERY SCHOOL (INF)	FACILITY NUMBER: 573619781
	VISIT DATE: 03/04/2024

NARRATIVE

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Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Exit interview conducted and report was reviewed with the facility representative, Carissa Crain. A notice of site visit was given and must remain posted for 30 days.

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

SUPERVISOR'S NAME: Chayntel Hunter	TELEPHONE: (916) 917-8620
LICENSING EVALUATOR NAME: Lauren Scott	TELEPHONE: (916) 926-9488
LICENSING EVALUATOR SIGNATURE:	DATE: 03/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2024

LIC809 (FAS) - (06/04)

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