313625187-10-20-2023-03-CC-AMAT-CWSTD2-20231020143737

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 313625187
Report Date: 10/20/2023
Date Signed: 10/20/2023 02:37:51 PM

Document Has Been Signed on 10/20/2023 02:37 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:	KIDZCOMMUNITY EARLY LEARNING CENTER, ROCK CREEK		FACILITY NUMBER:	313625187
ADMINISTRATOR:	BETHANY FIEGUTH		FACILITY TYPE:	830
ADDRESS:	3050 BELL ROAD		TELEPHONE:	(530) 886-4100
CITY:	AUBURN	STATE: CA	ZIP CODE:	95603
CAPACITY: 24	TOTAL ENROLLED CHILDREN: 24	CENSUS: 0	DATE:	10/20/2023
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Victoria Treadway and Vicky Lincoln		TIME COMPLETED:	02:35 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	Centralized Application Bureau (CAB) Licensing Program Analyst (LPA) Arianna Manabat and Licensing Program Analyst (LPA) Michelle Perez met with Facility Representatives VICTORIA TREADWAY and VICKY LINCOLN for the purpose of an announced pre-licensing change of location inspection. Licensee requests an infant license to serve 16 infant and toddler children from ages 0-24 months (with a maximum census of 4 infants under 12 months old due to 4 available cribs) and toddlers ages 18-36 months under the Toddler Option Program. The program will operate Monday through Friday from 8:30am-2:30pm. The fire clearance was received and granted. The facility will provide morning snack, lunch, and afternoon snacks. LPAs 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. INDOOR ACTIVITY SPACE: There are two large class areas located within one room. The two areas are divided via 4 foot fixed barriers. LPAs have observed that the sufficient amount of equipment and toys are currently at the old facility and will be relocated by the facility staff when the license is issued. LPAs observed that the facility does have tables, chairs, cubbies, and napping cots present within the current facility. The placement of the first aid kit will be in the backpack that is hanging on the walls. Medications will be stored in backpack out of reach of children. LPAs observed that cleaning disinfectants will be appropriately stored in the staff lounge inaccessible to children. Licensee stated there are no poisons or firearms on the premises. LPAs observed that the children will drink water from a water pitcher and cups next to the kitchen. LPAs observed a functional carbon monoxide detector. LPAs discussed sign in/sign out procedures will be conducted on paper sheets. *......Report continues on LIC809-C......*

SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Arianna Manabat
LICENSING EVALUATOR SIGNATURE:	DATE: 10/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2023

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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: KIDZCOMMUNITY EARLY LEARNING CENTER, ROCK CREEK	FACILITY NUMBER: 313625187
	VISIT DATE: 10/20/2023

NARRATIVE

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CAB LPA measured the classroom. The total classroom space contains a total of square feet 879.92 which will accommodate Licensee's request for 16 infant and toddler children. There is two toilets and two sinks for the children, and a separate private restroom for the staff is located outside of the facility on school campus. Individual measurements are recorded on the Capacity Worksheet (LIC 9024). Children who become ill during the day will be isolated in the office area and will use the staff restroom, if necessary.

OUTDOOR ACTIVITY SPACE:
There are two outdoor areas on the property. The outdoor play area is fenced with a rod iron fence that is at least four feet tall. LPAs observed a sufficient amount of equipment and toys. There is no play structure. There are no bodies of water on the premises. There are shaded areas supplied by trees and sides of the building.

CAB LPA measured the outdoor activity space. The infant outdoor play area contains a total of 1678.67 square feet, which will accommodate 8 infant children. The toddler outdoor play yard area contains 1762.28 square feet which will accommodate the requested 8 toddlers. Individual measurements are recorded on the Capacity Worksheet (LIC 9024).

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) or (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

LPAs discussed the following: 100% supervision is required at all times, including in the bathroom; personal rights; inspection authority; reporting requirements; staff to children ratios and capacity; staff qualifications; and maintaining buildings and grounds. LPAs discussed with Licensee 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.

Report continues on LIC809-C.

SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Arianna Manabat
LICENSING EVALUATOR SIGNATURE:	DATE: 10/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2023

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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: KIDZCOMMUNITY EARLY LEARNING CENTER, ROCK CREEK	FACILITY NUMBER: 313625187
	VISIT DATE: 10/20/2023

NARRATIVE

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Licensee was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated.

Licensee was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

LPAs discussed the safe sleep regulations with Assistant Director and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. AS also informed Assistant Director of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

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 at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

Exit interview conducted and report was reviewed with the Facility Representatives.

The following item is required before a license will be issued:
1. Ammended LIC200A with requested capacity for 16 total children; 8 toddlers and 8 infants.
2. Manager approval.

SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Arianna Manabat
LICENSING EVALUATOR SIGNATURE:	DATE: 10/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2023

LIC809 (FAS) - (06/04)

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