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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 283010043
Report Date: 11/05/2021
Date Signed: 11/12/2021 08:45:05 AM

Document Has Been Signed on 11/12/2021 08:45 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,
, CA
FACILITY NAME:LITTLE SUNSHINE LEARNING CENTER-INFANTFACILITY NUMBER:
283010043
ADMINISTRATOR:WHITESIDE, JULIETAFACILITY TYPE:
830
ADDRESS:15 WOODLAND ROADTELEPHONE:
(707) 786-2237
CITY:ST. HELENASTATE: CAZIP CODE:
94574
CAPACITY: 4TOTAL ENROLLED CHILDREN: 4CENSUS: 1DATE:
11/05/2021
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
09:20 AM
MET WITH:Amy Webster, Assistant DirectorTIME COMPLETED:
01:35 PM
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An annual required inspection was made to the facility by Licensing Program Analyst (LPA), Kevin O'Connell. The facility file was reviewed prior to this inspection. During today's inspection visit, the center director was not present at the center. The LPA met with the facility's assistant Director, Amy Webster. A review of the personnel report on 11/05/21 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. The facility representative was reminded that all adults 18 and over, 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.
The facility’s operating hours are 08:30am- 05:00pm, Monday – Thursday & 8am -4:30pm on Fridays.
This is a combination center with a preschool license as well. The facility was toured inside and outside and the floor and yard plan submitted by the licensee were verified. The 3 infants (under contract) are all currently under 12 months of age and share the large room. The items which could pose a danger to children (such as detergents, cleaning compounds and medications) were observed to be inaccessible to children. The toys, floors and other equipment are clean, safe and age appropriate for infants. There was a crib available for each infant still napping in a crib. Cribs at the facility are in compliance with the Department's new safe sleep regulations. The two vinyl padded changing tables are within arm's reach of one of two sinks.
No menus were posted as parents provide children's food. Food prep areas are clean. Food is properly stored and refrigerated and labeled as needed. There are no poisons or firearms and ammunition stored on the premises. The facility was free of flies, insects and rodents. There is drinking water available to children both indoors in the classrooms and outdoors on the playground. Garbage cans containing solid waste have tight fitting lids. The playground was free of hazards. The playground equipment and surface areas were in safe condition. There was vinyl padding under the climbing structure to absorb falls. There were no bodies of water observed. During today's inspection, staffing ratios were being met and there were two infants being supervised by one teacher. The facility was operating within the licensed capacity.
At least one staff member present during the visit possessed current CPR and First Aid certifications. Three children’s records were reviewed at 10:20am, and contained identification forms with authorized representative information, as well as medical assessments, infant 15- minute sleep check logs but did not contain two infant safe sleep plans (LIC 9227).
One staff record was reviewed at 11:15am for the required documents as specified in the entrance checklist. Continued on LIC 809-C
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Kevin O'Connell
LICENSING EVALUATOR SIGNATURE: DATE: 11/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/05/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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,
, CA
FACILITY NAME: LITTLE SUNSHINE LEARNING CENTER-INFANT
FACILITY NUMBER: 283010043
VISIT DATE: 11/05/2021
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LPA discussed the safe sleep regulations with the facility representative and discussed the Child Care Licensing Safe Sleep webpage athttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed the facility representative 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.

Incidental Medical Services (IMS) policy was discussed. 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

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the facility representative, Amy Webster. Tittle 22 regulation citation will be continued on LIC 809d.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.

SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Kevin O'Connell
LICENSING EVALUATOR SIGNATURE:

DATE: 11/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/05/2021
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Document Has Been Signed on 11/12/2021 08:45 AM - It Cannot Be Edited


Created By: Kevin O'Connell On 11/05/2021 at 12:53 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
,
, CA

FACILITY NAME: LITTLE SUNSHINE LEARNING CENTER-INFANT

FACILITY NUMBER: 283010043

DEFICIENCY INFORMATION FOR THIS PAGE:

VISIT DATE: 11/05/2021

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101419.2(b)(2)
Infant Needs and Services Plan
(b) The needs and services plan shall be in writing and shall include the following: (2) Infants up to 12 months of age shall have a completed Individual Infant Sleeping Plan [LIC 9227 (3/20)], which is incorporated by reference.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and record review, the licensee did not comply with the section cited above - Two Infant Needs & Services Plans were not available in two of the three children's files and Assistant Director states that they were not anywhere else in the facility which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/19/2021
Plan of Correction
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Assistant Director states that she will complete forms and have parents sign them and send copies to CCL by 11/19/21.
kevin.oconnell@dss.ca.gov
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Leslie Lepori
LICENSING EVALUATOR NAME:Kevin O'Connell
LICENSING EVALUATOR SIGNATURE:
DATE: 11/05/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/05/2021


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