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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313621197
Report Date: 09/05/2024
Date Signed: 09/05/2024 10:05:56 AM

Document Has Been Signed on 09/05/2024 10:05 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:CROSSROADS CHRISTIAN PRESCHOOLFACILITY NUMBER:
313621197
ADMINISTRATOR/
DIRECTOR:		WHITLEY, SHELBYFACILITY TYPE:
850
ADDRESS:202 DAIRY ROADTELEPHONE:
(530) 885-4726
CITY:AUBURNSTATE: CAZIP CODE:
95603
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 21DATE:
09/05/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Shelby WhitleyTIME VISIT/
INSPECTION COMPLETED:
10:30 AM
NARRATIVE
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On 9/5/2024 at approximately 9:00AM, Licensing Program Analyst (LPA) Michelle Perez met with director, Shelby Whitley for an unannounced annual inspection. LPA observed a census of 21 preschool age children with 3 fully qualified staff. Facility hours of operation are Monday through Friday, 7:30 am to 5:30 pm.

LPA inspected all activity and classroom spaces, restrooms, food service, and outdoor play areas. Hazardous items are inaccessible to children. Furniture and equipment are in operable and safe condition. Playground equipment and surfaces are free of loose or sharp parts, adequate cushioning was observed in areas underneath climbing equipment, and adequate shading provided. Toileting facilities are in safe, sanitary, and operating condition. The floors appeared clean throughout the facility. Storage containers with solid waste have tight-fitting covers in each classroom. Children bring lunches and facility provides AM and PM snack. Drinking water was readily available to children both indoors and outdoors via their own water bottles. Medications are appropriately stored and inaccessible to children, when they are in the facility.

Facility uses full legal signatures for sign in/sign out records via Bright-wheel.

SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Michelle Perez
LICENSING EVALUATOR SIGNATURE: DATE: 09/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/05/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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Document Has Been Signed on 09/05/2024 10:05 AM - It Cannot Be Edited


Created By: Michelle Perez On 09/05/2024 at 09:39 AM
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
, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: CROSSROADS CHRISTIAN PRESCHOOL
FACILITY NUMBER: 313621197

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/05/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observationand interview the licensee did not comply with the section cited above in 2 out of 3 teachers had expired mandated reporter certificates which posesa potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/13/2024
Plan of Correction
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Licensee will submit to LPA proof of current mandated reporter certificate via e-mail by POC date.
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:Keven Peters
LICENSING EVALUATOR NAME:Michelle Perez
LICENSING EVALUATOR SIGNATURE:
DATE: 09/05/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/05/2024


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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: CROSSROADS CHRISTIAN PRESCHOOL
FACILITY NUMBER: 313621197
VISIT DATE: 09/05/2024
NARRATIVE
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Children records were reviewed, it was observed that each child's file contained appropriate documentation. Staff records were reviewed for all present staff. At least one staff member present today has current Pediatric CPR and First Aid certification which expires 07/2025. All staff currently employed with the facility have complete files including a criminal record clearance, a health screening report, immunization records, AB1207 Mandated Reporter Training was expired for two staff. Documentation of their educational background, training, and/or experience. Facility is aware that mandated reporter training is to be renewed every two- years along with CPR.

Incidental Medical Services (IMS) policy was discussed. Currently the facility does not have any children on medication. 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. There are currently no children on IMS plans.

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 informed the Director about Assembly Bill 2370, which will require certain licensed Child Care Facilities to test their water for excessive amounts of lead. Testing will be required beginning January 1, 2023. Facility will be tested every 5-years.

SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Michelle Perez
LICENSING EVALUATOR SIGNATURE:

DATE: 09/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/05/2024
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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: CROSSROADS CHRISTIAN PRESCHOOL
FACILITY NUMBER: 313621197
VISIT DATE: 09/05/2024
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LPA encouraged the Director was encouraged to the visit the Department's website at WWW.CDSS.CA.GOV for information regarding childcare updates, forms, regulations, and legislation pertaining childcare centers. LPA also encouraged the Director to sign up for the Child Care Advocates quarterly newsletter.

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

Based on today’s inspection, a title 22 Deficiency is being cited

This report was reviewed with Director, Shelby Whitley and an exit interview was conducted.



A Notice of Site Visit was provided and must remain posted for 30 days.
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Michelle Perez
LICENSING EVALUATOR SIGNATURE:

DATE: 09/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/05/2024
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