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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 340314888
Report Date: 04/22/2024
Date Signed: 04/22/2024 10:09:25 AM

Document Has Been Signed on 04/22/2024 10:09 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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:LICHEN HEAD START PRESCHOOLFACILITY NUMBER:
340314888
ADMINISTRATOR/
DIRECTOR:
SHEELY, CAROLFACILITY TYPE:
850
ADDRESS:8319 LICHEN DRIVETELEPHONE:
(916) 728-3230
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95621
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 15DATE:
04/22/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:45 AM
MET WITH:Carol SheelyTIME VISIT/
INSPECTION COMPLETED:
10:30 AM
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On 4/22/2024 at approximately 08:45AM Licensing Program Analyst (LPA) Michelle Perez met with director Carol Sheely for an unannounced inspection. LPA observed a cenus of 15 preschool age children with 3 staff. Two fully qualified staff. Facility hours of operation are Monday, Tuesday, Wednesday & Friday 8:30AM to 3PM & Thursday 8:30-12:15PM.

LPA inspected all activity and classroom spaces, restrooms, food service, and outdoor play areas. Hazardous items are inaccessible to children. Furniture and equipment are in operable and safe condition. Playground equipment and surfaces are free of loose or sharp parts, adequate cushioning was observed in areas underneath climbing equipment, and adequate shading provided. Toileting facilities are in safe, sanitary, and operating condition. The floors appeared clean throughout the facility. Storage containers with solid waste have tight-fitting covers in each classroom. Menus were posted for AM/PM snack and lunch, which is prepared by facility. Drinking water was readily available to children both indoors and outdoors via fountains. Medications are appropriately stored and inaccessible to children. Facility uses full legal signatures for sign in/sign out records.

SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Michelle Perez
LICENSING EVALUATOR SIGNATURE: DATE: 04/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/22/2024
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: LICHEN HEAD START PRESCHOOL
FACILITY NUMBER: 340314888
VISIT DATE: 04/22/2024
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Children records were reviewed, it was observed that each child's file contained appropriate documentation. Staff records were reviewed for all present staff. At least one staff member present today has current Pediatric CPR and First Aid certification which expires 7/2024. All staff currently employed with the facility have complete files including a criminal record clearance, a health screening report, immunization records, Mandated Reporter Training expires March 2026. Documentation of their educational background, training, and/or experience is present in each file.

Incidental Medical Services (IMS) policy was discussed. The facility is currently providing IMS. 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 informed the Director about Assembly Bill 2370, which will require certain licensed Child Care Facilities to test their water for excessive amounts of lead. Testing will be required beginning January 1, 2023 and every 5-years thereafter.

SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Michelle Perez
LICENSING EVALUATOR SIGNATURE:

DATE: 04/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/22/2024
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: LICHEN HEAD START PRESCHOOL
FACILITY NUMBER: 340314888
VISIT DATE: 04/22/2024
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LPA encouraged the Director was encouraged to the visit the Department's website at WWW.CDSS.CA.GOV for information regarding childcare updates, forms, regulations, and legislation pertaining childcare centers. LPA also encouraged the Director to sign up for the Child Care Advocates quarterly newsletter.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

Based on today’s inspection, no title 22 Deficiencies are being cited.

This report was reviewed with Director, and an exit interview was conducted.

SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Michelle Perez
LICENSING EVALUATOR SIGNATURE:

DATE: 04/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/22/2024
LIC809 (FAS) - (06/04)
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