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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313624491
Report Date: 09/30/2022
Date Signed: 09/30/2022 10:44:29 AM

Document Has Been Signed on 09/30/2022 10:44 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:SMART STARTFACILITY NUMBER:
313624491
ADMINISTRATOR:BREANA BAKERFACILITY TYPE:
850
ADDRESS:7117 HOPE WAYTELEPHONE:
(916) 755-2111
CITY:PENRYNSTATE: CAZIP CODE:
95663
CAPACITY: 45TOTAL ENROLLED CHILDREN: 45CENSUS: 36DATE:
09/30/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Breana BakerTIME COMPLETED:
11:00 AM
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On September 30th, 2022, Licensing Program Analyst (LPA) Kelly Ferrara met with Applicant Breana Baker for the purpose of an announced pre-licensing inspection. Applicant request a preschool license to serve 45 preschool children ages 2 to 5. The facility is located on the grounds of Hope Lutheran Church. The program will operate Monday through Friday from 8 AM to 3 PM. The program has a morning group from 8:15 AM to 11:15 AM and an afternoon group from 11:45 AM to 2:45 PM. The facility will follow the school district schedule and close during the summer and holiday breaks. The facility received an approved fire clearance on September 29th, 2022 from the Penryn Fire Department.

LPA reviewed with applicant the LIC 311A, Records To Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted. Applicant acknowledges that the following documents must be posted at all times: License, Emergency Disaster Plan, Personal Rights, Parents' Rights Poster, Effects of Lead Exposure, car seat poster, and daily schedule. Applicant stated the parents will provide snack and lunches for the children, however the facility has back up snack and lunch items.

INDOOR ACTIVITY SPACE:
The facility consists of three preschool classrooms. LPA observed sufficient amount of age-appropriate equipment, toys, tables, and cubbies. There is a first aid kit and an area to store medications. Applicant stated there are no firearms or weapon on the premises and LPA did not observe any bodies of water. Applicant stated indoor and outdoor drinking water will be available by using individual water bottles that children bring from home, that will be refilled with water from the sink. LPA observed a functioning smoke and carbon monoxide detector. LPA observed a binder where children are signed in and out of the facility. The facility also uses an app to sign children in.

Continued on 809-C
SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Kelly Ferrara
LICENSING EVALUATOR SIGNATURE: DATE: 09/30/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/30/2022
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: SMART START
FACILITY NUMBER: 313624491
VISIT DATE: 09/30/2022
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LPA used previous measurements taken on March 26th, 2019 from the former facility. The three rooms contain a total of 2,049 square feet which will accommodate the applicant's request for 45 preschoolers. There are a total of three toilets, one urinal, and five sinks available for children to use in the facility. There is a separate private restroom for the staff inside the church. Children who become ill during the day will be isolated in the office.

OUTDOOR ACTIVITY SPACE:
There is an outdoor activity space for the preschool which is surrounded by a fence that is at least four feet tall. The playground has a play structure that is anchored to the ground with enough bark to absorb a fall. LPA observed sufficient amount of age appropriate equipment and toys. There are shaded areas supplied by trees and overhangs. LPA used outdoor measurements taken on March 26th, 2019. The preschool playground contained a total of 20,381 square feet, sufficient outdoor activity space to support the requested capacity. There is a separate fenced off playground that the children do not use that belongs to the church.

LPA discussed the following: 100% supervision is required at all times; personal rights; inspection authority; reporting requirements; staff to children ratios and capacity; staff qualifications; and maintaining buildings and grounds. LPA discussed with Applicant any changes that may occur regarding the director or an employee acting in the director's absence must be reported to department within 10 working days.

This facility plans to provide Incidental Medical Services – IMS. For IMS information, see PIN 22-02-CCP. A 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.

Applicant 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.

Continued on 809-C
SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Kelly Ferrara
LICENSING EVALUATOR SIGNATURE:

DATE: 09/30/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2022
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: SMART START
FACILITY NUMBER: 313624491
VISIT DATE: 09/30/2022
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Applicant was encouraged to visit the Department website at WWW.CCLD.CA.GOV for child care updates, current forms, legislation and regulation information. A copy of this report will remain on file for a period of three years for public review upon request.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform. To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website athttps://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

The following items are required before a license will be issued:

1. Licensing Program Manager’s final review.

Exit interview was conducted and report was reviewed with Applicant Breana Baker.
SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Kelly Ferrara
LICENSING EVALUATOR SIGNATURE:

DATE: 09/30/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2022
LIC809 (FAS) - (06/04)
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