293622663-3-14-2024-03-CC-MGAO-D3CP9N-20240314110726

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 293622663
Report Date: 02/22/2024
Date Signed: 03/14/2024 11:07:29 AM

Document Has Been Signed on 03/14/2024 11:07 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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME:	IRON AND PINE PRESCHOOL		FACILITY NUMBER:	293622663
ADMINISTRATOR:	DIVINE, JESSICA		FACILITY TYPE:	850
ADDRESS:	215 WASHINGTON ST		TELEPHONE:	(530) 955-5214
CITY:	NEVADA CITY	STATE: CA	ZIP CODE:	95959
CAPACITY: 24	TOTAL ENROLLED CHILDREN: 24	CENSUS: 8	DATE:	02/22/2024
TYPE OF VISIT:	POC	UNANNOUNCED	TIME BEGAN:	09:20 AM
MET WITH:	Jessica Divine		TIME COMPLETED:	12:30 PM

NARRATIVE

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*This report was originally drafted during a visit on 2/22/2024. On that day, computer issues prevented the collection of signatures and final printing. Visit conducted on 3/14/2024 to complete report.*

At 9:20am on 2/22/2024, Licensing Program Analyst (LPA) Matthew Gallo met with Director Jessica Divine for the purpose of conducting a Plan of Correction visit. Today’s census included 8 preschool children.

Facility was previously cited two Type A deficiencies on 2/14/24 for (1) ratio and (2) unqualified staff. The plan of correction for the ratio deficiency dictated that the facility would send LPA a schedule of staff that shows ratio being maintained at all times and that the LPA would conduct a follow up visit to ensure compliance. The plan of correction for the unqualified staff deficiency dictated that the facility would similarly send LPA a schedule of staff to show that a qualified teacher will be present at all times and that LPA would conduct a return visit to ensure compliance. LPA observed the facility to be in compliance with both plans of correction.

The plans of correction for both deficiencies cited on 2/14/2024 have been cleared.

Exit interview conducted and report was reviewed with the Director Jessica Divine. A notice of site visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Matthew Gallo
LICENSING EVALUATOR SIGNATURE:	DATE: 03/14/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2024

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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