045408225-3-15-2023-13-CC-LCHZ-CPXQ7P-20230315115528

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 045408225
Report Date: 03/02/2023
Date Signed: 03/15/2023 11:55:37 AM

Document Has Been Signed on 03/15/2023 11:55 AM - It Cannot Be Edited

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:	ACORNS TO OAKS PRESCHOOL AND DAYCARE LLC		FACILITY NUMBER:	045408225
ADMINISTRATOR:	SIVADON, SHANNON		FACILITY TYPE:	850
ADDRESS:	2452 TOM POLK AVE		TELEPHONE:	(530) 520-0251
CITY:	CHICO	STATE: CA	ZIP CODE:	95926
CAPACITY:	40	CENSUS: 0	DATE:	03/02/2023
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	08:05 AM
MET WITH:	Erica Metzen and Shannon Sivadon		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	A prelicensing inspection was conducted today at 8:05am by Licensing Program Analyst (LPA), Laura Chavez. LPA met with applicants Erica Metzen and Shannon Sivadon. The applicants are requesting a license for preschool age children, with a capacity of 40. The facility will operate Monday-Friday, 7am to 6pm. The facility has two classrooms (Owl and Fox) and a communal area for children to use. There are two bathrooms for children to use. The indoor and outdoor activity spaces were toured, and the facility sketch was verified. The following areas will be off limits to children: office, kitchen and janitorial/storage closet. These areas have been made inaccessible by means of locks. There is a kitchen to prepare meals. Children will nap on mats in the classrooms and/or the communal area. The isolation area for sick children will be located in the office. A changing table is located in the Fox Classroom and within arms reach of a sink. . The outdoor play area is fully fenced. There are climbing structures, swings, child size tables, and tricycles for children to play on and adequate cushioning underneath. There is no pool, spa, pond, fountain, or any other body of water on the premises. The poisons are locked in the janitorial closet. There is safe and age appropriate furniture, toys, and play equipment available for children. A capacity worksheet was completed during the visit. There is enough indoor space for 40 children and outdoor space for 75 children. There are 3 toilets and three sinks available for children. Based on the above, the maximum capacity of the facility could be 40. A waiver request is requesting to allow preschool staff to use the bathroom located in the infant building located across the preschool building.

SUPERVISOR'S NAME: Megan Aviles	TELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Laura Chavez	TELEPHONE: (530) 895-5914
LICENSING EVALUATOR SIGNATURE:	DATE: 03/02/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2023

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, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME: ACORNS TO OAKS PRESCHOOL AND DAYCARE LLC	FACILITY NUMBER: 045408225
	VISIT DATE: 03/02/2023

NARRATIVE

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LPA reviewed with the applicants the LIC 311A, Records To Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted. Applicants were 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.

The following items need to be completed prior to the granting of license:

1. Proof of nails removed or nailed into the corner fence 4x4.
2. Proof of the replacing the fence board missing from the back corner portion of the fence.
2. Manager review of the waiver request for preschool age children to share the outdoor
play area with infants.

Exit interview conducted and report was reviewed with the applicants Erica Metzen and Shannon Sivadon.

SUPERVISOR'S NAME: Megan Aviles	TELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Laura Chavez	TELEPHONE: (530) 895-5914
LICENSING EVALUATOR SIGNATURE:	DATE: 03/02/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2023

LIC809 (FAS) - (06/04)

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