574500528-1-31-2022-53-CC-ASIS-CB7PFJ-20220131101649

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 574500528
Report Date: 01/31/2022
Date Signed: 01/31/2022 10:18:27 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 CHRISTIAN PRESCHOOL AND DAY CARE CENTER		FACILITY NUMBER:	574500528
ADMINISTRATOR:	TAMMY TEDFORD		FACILITY TYPE:	850
ADDRESS:	1787 MATMOR RD.		TELEPHONE:	(530) 662-0994
CITY:	WOODLAND	STATE: CA	ZIP CODE:	95776
CAPACITY:	125	CENSUS: 0	DATE:	01/31/2022
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Tammy Tedford		TIME COMPLETED:	10:30 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	Application Specialist (AS) Alecia Sifuentes met with Facility Representative/Director, Tammy Tedford for the purpose of an announced change of location and change of capacity inspection. Director requests a preschool license to serve 125 preschool children from age two to entry into kindergarten. The program will operate Monday through Friday from 7:00 a.m. to 6:00 p.m. The fire clearance was granted and received on 1/27/2022. The facility will provide breakfast, lunch, and afternoon snacks. AS reviewed with Director the LIC 311A, Records To Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted. AS discussed the safe sleep regulations with Director and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. AS also informed Director 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. INDOOR ACTIVITY SPACE: There are three preschool classrooms. Director stated that the equipment, toys, tables, chairs, cubbies, and napping mats are currently located at the other site and will be moved over. First aid kit and medication is located in the work room in a lock box. AS observed cleaning disinfectants are appropriately stored and inaccessible to children. Director stated there are no poisons or firearms on the premises. Director stated that children will bring water bottles to refill in the classroom. AS observed a functional dual smoke and carbon monoxide detector in each classroom. AS observed sign-in/sign-out binders. Report continues on 809-C.

SUPERVISOR'S NAME: Jeanne Smith	TELEPHONE: (916) 208-4405
LICENSING EVALUATOR NAME: Alecia Sifuentes	TELEPHONE: (916) 917-9202
LICENSING EVALUATOR SIGNATURE:	DATE: 01/31/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2022

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, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME: WOODLAND CHRISTIAN PRESCHOOL AND DAY CARE CENTER	FACILITY NUMBER: 574500528
	VISIT DATE: 01/31/2022

NARRATIVE

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AS measured three classrooms. The total classroom space contains a total of 4675.721 square feet, which will accommodate Director’s request for 125 preschool children. There are 9 toilets and 12 sinks for the children, and a separate private restroom for the staff. Individual measurements are recorded on the Capacity Worksheet (LIC 9024). Children who become ill during the day will be isolated in the office area and will use the staff restroom, if necessary.

OUTDOOR ACTIVITY SPACE:
There is one outdoor area on the property. The outdoor play area is fenced with a chain link fence that is at least four feet tall. Director stated that the equipment and toys are currently at the other site and we be moved over. The play structure includes a safety label, which designates use for children 2 to 5 years old. There are no bodies of water on the premises. There are shaded areas supplied by two canopies and overhangs.

AS measured the outdoor activity space. The outdoor play area contains a total of 9511.971 square feet, which will accommodate Director's request for 125 preschool children. Individual measurements are recorded on the Capacity Worksheet (LIC 9024).

This facility plans to provide Incidental Medical Services – IMS. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. A 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

Report continues on 809-C.

SUPERVISOR'S NAME: Jeanne Smith	TELEPHONE: (916) 208-4405
LICENSING EVALUATOR NAME: Alecia Sifuentes	TELEPHONE: (916) 917-9202
LICENSING EVALUATOR SIGNATURE:	DATE: 01/31/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2022

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, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME: WOODLAND CHRISTIAN PRESCHOOL AND DAY CARE CENTER	FACILITY NUMBER: 574500528
	VISIT DATE: 01/31/2022

NARRATIVE

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AS discussed the following: 100% supervision is required at all times, including in the bathroom; personal rights; inspection authority; reporting requirements; staff to children ratios and capacity; staff qualifications; and maintaining buildings and grounds. AS discussed with Director any changes that may occur regarding the director or an employee acting in the director's absence must be reported to department within 10 working days.

Director was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform. To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

Exit interview conducted and report was reviewed with the Director, Tammy Tedford.

Director stated that the current site is still in operation and the last day will be 2/11/2022. Director has requested 2/14/2022 to be the effective date for the new location. AS will approve the facility for a capacity of 125 children licensed to serve children from age two years to entry into kindergarten.

SUPERVISOR'S NAME: Jeanne Smith	TELEPHONE: (916) 208-4405
LICENSING EVALUATOR NAME: Alecia Sifuentes	TELEPHONE: (916) 917-9202
LICENSING EVALUATOR SIGNATURE:	DATE: 01/31/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2022

LIC809 (FAS) - (06/04)

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