293622664-7-28-2023-03-CC-MGAO-CU6P6C-20230728110207

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 293622664
Report Date: 07/28/2023
Date Signed: 07/28/2023 11:02:12 AM

Document Has Been Signed on 07/28/2023 11:02 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:	LITTLE CREEK PRESCHOOL		FACILITY NUMBER:	293622664
ADMINISTRATOR:	DELGADO, JANET		FACILITY TYPE:	850
ADDRESS:	10085 ADAM AVENUE		TELEPHONE:	(530) 272-6060
CITY:	GRASS VALLEY	STATE: CA	ZIP CODE:	95945
CAPACITY: 12	TOTAL ENROLLED CHILDREN: 12	CENSUS: 0	DATE:	07/28/2023
TYPE OF VISIT:	Case Management - Other	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Angelyn Wahl and Karin Meadows		TIME COMPLETED:	11:10 AM

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Licensing Program Analyst (LPA) Matthew Gallo met with administrator Karin Meadows and director Angelyn Wahl for a case management meeting with the purpose of changing the facility status from inactive to active. Program intends to renew services on 8/21/2023 and operate in conjunction with the school year.

LPA toured the building including all activity and classroom spaces, restrooms, food service and outdoor play areas. The classroom remains in room 303B. All necessary postings were observed. Furniture and equipment were in good condition, and floors were clean throughout the facility. All toxic and hazardous items were inaccessible to children. Functional carbon monoxide detector and smoke detector were present, along with a 2A10BC fire extinguisher that meets regulation. Facility will provide morning and afternoon snack along with lunch, and menus were posted in visible sight. The food preparation area was free of litter and all food was protected against contamination. Drinking water was readily available to children both indoors and outdoors.

Outdoor play area consists of the fenced yard adjacent to the entrance of the classroom. Playground equipment and surfaces were free of loose or sharp parts, and the areas underneath or around climbing equipment were sufficiently cushioned with wood chips. There are no bodies of water or poisons on the premises.

Staff and records were reviewed and observed to be complete. Review of staff records confirmed at least one staff member present today has current Pediatric CPR and First Aid certification, and that all staff currently employed with the facility have valid AB1207 Manded Reporter Training certificates. 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.

Report continues on 809-C.

SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Matthew Gallo
LICENSING EVALUATOR SIGNATURE:	DATE: 07/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2023

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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: LITTLE CREEK PRESCHOOL	FACILITY NUMBER: 293622664
	VISIT DATE: 07/28/2023

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Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual-Regulation Interpretations and Procedures for Family Child Care Homes Sections 102417. 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

LPA discussed Assembly Bill 2370, which required licensed Child Care facilities to test their water for excessive amounts of lead, and confirmed compliance. LPA reminded licensee that testing must be conducted every five years from initial testing.

Director was encouraged to the visit the departments website at WWW.CCLD.CA.GOV for information regarding childcare updates, forms, regulations and legislation pertaining child care centers.

No deficiencies were cited during today's inspection. As of today, 7/28/2023, the facility will return to active status.

SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Matthew Gallo
LICENSING EVALUATOR SIGNATURE:	DATE: 07/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2023

LIC809 (FAS) - (06/04)

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