313624423-8-22-2024-03-CC-LHAM-D8DTE8-20240822143930

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 313624423
Report Date: 08/22/2024
Date Signed: 08/22/2024 02:39:34 PM

Document Has Been Signed on 08/22/2024 02:39 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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME:	CREEKSIDE OAKS ELEMENTARY PRESCHOOL		FACILITY NUMBER:	313624423
ADMINISTRATOR/ DIRECTOR:	AIMEE BOUCHER		FACILITY TYPE:	850
ADDRESS:	2030 1ST ST		TELEPHONE:	(530) 745-1380
CITY:	LINCOLN	STATE: CA	ZIP CODE:	95648
CAPACITY: 24	TOTAL ENROLLED CHILDREN: 24	CENSUS: 15	DATE:	08/22/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	01:35 PM
MET WITH:	Maria Carmen		TIME VISIT/ INSPECTION COMPLETED:	02:45 PM

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On August 22, 2024, an unannounced annual/random inspection is made today by Licensing Program Analyst (LPA) Lea Habtom. LPA Habtom met with Maria Carmen, lead teacher. There were 5 staff supervising 15 preschool children. The preschool is located on the Creekside Oaks Elementary School campus. The program provides two part-time programs Monday- Friday from 8:00 am- 11:00 am and 12:00 pm- 3:00 pm.

The following areas are in compliance during inspection: There are no bodies of water. Firearms and ammunition are not on the premises. There are no poisons on the premises. Disinfectants, hazardous items and medications are inaccessible to children. Furniture and equipment are sufficient, age appropriate and in good repair. The facility share the use of the elementary school playground. Bathroom was clean and toilets and sinks were in working condition. Classroom is safe and clean. Carbon Monoxide detector is on the premises. Storage containers for solid waste are covered. Drinking water is available both indoors and outside. Menus are posted. The facility provides an AM and PM snack. Children do not nap. The facility is in compliance with conditions and limitations specified on the license. Teacher/child ratios are maintained and adequate supervision is being provided during this inspection. There is adequate space for children belongings. All waivers are being followed.

Criminal record clearances and/or exemptions are completed by Placer County Office of Education (PCOE). 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. First Aid/CPR reviewed and in compliance. Emergency information reviewed for some children. Staff records reviewed. Children files reviewed.
LPA observed proof that all staff/ volunteers have met the requirements of SB 792.

LPA observed that all staff has completed the required mandated reporter training (AB 1207) at website: www.mandatedreporterca.com

Report continued on 809-C

SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Lea Habtom
LICENSING EVALUATOR SIGNATURE:	DATE: 08/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2024

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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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: CREEKSIDE OAKS ELEMENTARY PRESCHOOL	FACILITY NUMBER: 313624423
	VISIT DATE: 08/22/2024

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LPA provided the Community Care Licensing website www.ccld.ca.gov, so the licensee can obtain updated licensing information, new regulations and access forms. LPA advised licensee of their responsibility to stay current in regards to new regulations. LPA also included the email address for the children's advocacy program to stay current on new laws childcareadvocatesprogram@dss.ca.gov.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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

No deficiencies observed in the areas inspected during today's inspection.
A notice of site visit was provided to be posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. Appeal rights provided.

Exit interview conducted and report was reviewed with the facility representative Maria Carmen,

SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Lea Habtom
LICENSING EVALUATOR SIGNATURE:	DATE: 08/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2024

LIC809 (FAS) - (06/04)

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