313624817-3-30-2023-03-CC-MLOR-CQESEA-20230330134825

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 313624817
Report Date: 03/30/2023
Date Signed: 03/30/2023 01:48:34 PM

Document Has Been Signed on 03/30/2023 01:48 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
RIVER CITY (SACTO)CC, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME:	BELLS PRESCHOOL & CHILDCARE		FACILITY NUMBER:	313624817
ADMINISTRATOR:	ASHESH KUMAR SINGH		FACILITY TYPE:	840
ADDRESS:	10810 ATWOOD ROAD		TELEPHONE:	(408) 464-3131
CITY:	AUBURN	STATE: CA	ZIP CODE:	95603
CAPACITY: 24	TOTAL ENROLLED CHILDREN: 24	CENSUS: 0	DATE:	03/30/2023
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Ashesh Kumar Singh		TIME COMPLETED:	02:00 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Application Specialist (AS) Mai Lor and Licensing Program Analyst (LPA) Lea Habtom met with Ashesh Kumar Singh for the purpose of an announced pre-licensing inspection. Applicant is requesting a school-age license to serve 24 school-age children enrolled in first grade and above. The program will operate Monday through Friday from 6:00 AM to 6:00 PM. The fire clearance was granted on 02/16/2023. 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, menus, and daily schedule. Entrance Checklist was provided to the applicant. INDOOR ACTIVITY SPACE: There is one school-age classroom and a kitchen to support food preparation. AS and LPA observed a sufficient amount of equipment, toys, tables, and cubbies. There is a first aid kit in the classroom. Applicant stated medications will stored in the kitchen and inaccessible to children. Applicant stated there are no firearms or weapon on the premises. AS and LPA observed drinking fountains throughout the classrooms and one drinking fountain in the preschool play yard. AS and LPA observed a functional carbon monoxide detector in the facility. Applicant stated the facility will be utilizing an electronic sign in and sign out system. Applicant stated the facility will provide morning and afternoon snack. Parents will be responsible for lunch. AS and LPA measured the classroom space. The total classroom space contains a total of 840.59 square feet, which will accommodate the requested capacity for 24 school-age children. There is a total of five toilets and five sinks, which one of the sinks is located in the preschool play yard. There are two toilets with privacy located in the school age classroom which will be designated for the school-age children. (Report continues on subsequent LIC 809)

SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Mai Lor
LICENSING EVALUATOR SIGNATURE:	DATE: 03/30/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/30/2023

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
RIVER CITY (SACTO)CC, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: BELLS PRESCHOOL & CHILDCARE	FACILITY NUMBER: 313624817
	VISIT DATE: 03/30/2023

NARRATIVE

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There is a separate private restroom for the staff. Children who become ill during the day will be isolated in office and will use the staff restroom room, if necessary.

OUTDOOR ACTIVITY SPACE:
There is an outdoor activity space for school age children. The outdoor play area is surrounded fence that is at least four feet tall and separate from the preschool yard. There is a swing set and a metal climbing dome. AS and LPA observed sand used as cushioned under climbing structures. AS and LPA observed sufficient amount of age-appropriate equipment and toys. There are shaded areas supplied by trees and overhangs.

AS and LPA measured the outdoor space. The outdoor play area contains a total of 9,715.13 square feet, which will accommodate Applicant's request for 24 school-age children.

AS 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. AS 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.

Prior to this inspection, AS emailed Effects of Lead Exposure brochure and Provider Notice Information (PIN) 21-21 (Release of the Written Directives for Lead Testing of Water in Licensed Child Care Centers per AB 2370). AS and LPA reviewed lead testing requirement and COVID-19 technical assistance with the applicant.

AS 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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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

(Report continues on subsequent LIC 809)

SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Mai Lor
LICENSING EVALUATOR SIGNATURE:	DATE: 03/30/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/30/2023

LIC809 (FAS) - (06/04)

Page: 2 of 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVER CITY (SACTO)CC, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: BELLS PRESCHOOL & CHILDCARE	FACILITY NUMBER: 313624817
	VISIT DATE: 03/30/2023

NARRATIVE

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Licensee 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.

Licensee 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.

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

1. Lease agreement

2. Pending Licensing Program Manager Keven Peter’s final review

Exit interview conducted and report was reviewed with the Applicant, Ashesh Kumar Singh

SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Mai Lor
LICENSING EVALUATOR SIGNATURE:	DATE: 03/30/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/30/2023

LIC809 (FAS) - (06/04)

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