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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313623318
Report Date: 10/06/2021
Date Signed: 10/06/2021 12:45:15 PM

Document Has Been Signed on 10/06/2021 12:45 PM - 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, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:LILY PAD EARLY LEARNING CENTER, INC.FACILITY NUMBER:
313623318
ADMINISTRATOR:ZEMLICKA, MICHELLEFACILITY TYPE:
850
ADDRESS:1388 LINCOLN WAYTELEPHONE:
(530) 863-9443
CITY:AUBURNSTATE: CAZIP CODE:
95603
CAPACITY: 33TOTAL ENROLLED CHILDREN: 0CENSUS: 27DATE:
10/06/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Michelle ZemlickaTIME COMPLETED:
12:00 PM
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Licensing Program Analyst (LPA) Gagandeep Singh met with the facility representative, Michelle Zemlicka, for an annual inspection. Purpose of the inspection was explained. Present, there are 27 children with four teachers and the director. Facility is operating with in the capacity and in compliance with staff child ratio on this day. Facility operate day care from Monday to Friday between 6:30 AM to 5:30 PM.

With facility representative, LPA inspected the day care classrooms: Room # 6, 7, PreK room, Bathrooms and the play yard. There are no pools, spas or other bodies of water at the facility. Facility has multiple smoke detectors, carbon monoxide detectors, first aid supplies and fully charged fire extinguishers at the site. All of the cleaning solutions, poisons and other chemicals that are dangerous to the children are stored inaccessible to the children. Facility has age appropriate furniture. Furniture is steady and in good repair. All toilets, hand washing facilities are in working condition with proper sanitation in place. All storage containers for solid waste and in good repair and have proper tight-fitted lid on top. Facility has drinking water available for children. All unused electrical outlets have child protective covers installed. Play yard is free of hazards. All of the play structures are steady, in good repair and free of any loose parts. There is sufficient amount of wood chips under the play structures to prevent any fall injuries.

LPA reviewed the facility records. LPA observed that facility has license and all other required documents posted and visible for public. Facility has well maintained roster available on site. LPA reviewed 10 random children's and all present staff's files. LPA observed facility has record of names, addresses and telephone numbers of each child's authorized representative. Each child's record contains record of child’s immunization. Multiple staff members has record of valid CPR training certificate in file. LPA reviewed the educational qualification of all the teachers. LPA observed all present staff has record of receiving required immunization.
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SUPERVISORS NAME: Maria Mayorga
LICENSING EVALUATOR NAME: Gagandeep Singh
LICENSING EVALUATOR SIGNATURE: DATE: 10/06/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/06/2021
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, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME: LILY PAD EARLY LEARNING CENTER, INC.
FACILITY NUMBER: 313623318
VISIT DATE: 10/06/2021
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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


LPA reminded the facility representative that fire/earthquake drills must be conducted at least once every six months and must be documented. The facility has a log in place and per log, last drill was conducted on September 28, 2021. LPA reminded the facility represent that all staff is required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com. LPA observed the completion certificates on file for the present staff.

LPA reminded the facility representative that all adults, 18 years and older, must have criminal record clearance and must be associated to the facility prior to having any contact with children in care. Failure to do so could result in an immediate civil penalty of $100.00 each day.

LPA encourages the director to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates. Licensee can also email at childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list for the updates.

No deficiencies are cited today. The copy of this report is reviewed and provided to the director. Notice of site visit is posted and shall remain posted for next 30 days.
SUPERVISORS NAME: Maria Mayorga
LICENSING EVALUATOR NAME: Gagandeep Singh
LICENSING EVALUATOR SIGNATURE:

DATE: 10/06/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/06/2021
LIC809 (FAS) - (06/04)
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