343624320-6-24-2022-03-CC-KFEA-CFPR6W-20220624124525

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343624320
Report Date: 06/24/2022
Date Signed: 06/24/2022 12:45:34 PM

Document Has Been Signed on 06/24/2022 12:45 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME:	FOLSOM PREP		FACILITY NUMBER:	343624320
ADMINISTRATOR:	MURAWSKI, CANDIS		FACILITY TYPE:	850
ADDRESS:	650 WILLARD DRIVE		TELEPHONE:	(916) 524-5372
CITY:	FOLSOM	STATE: CA	ZIP CODE:	95630
CAPACITY: 24	TOTAL ENROLLED CHILDREN: 24	CENSUS: 0	DATE:	06/24/2022
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	11:45 AM
MET WITH:	Candis Murawski		TIME COMPLETED:	01:00 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	Licensing Program Analysts (LPAs) Kelly Ferrara and Alize Tillery met with Applicant Candis Murawski for the purpose of an announced pre-licensing inspection. Applicant is requesting a preschool license to serve 15 preschool children from age two years to entry into first grade. The program will operate Monday through Friday from 6:30 to 6 PM. The fire clearance was granted on 5/3/22 by the Folsom Fire Department. 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. 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. Applicant acknowledges that the following documents must always be posted : License, Emergency Disaster Plan, Personal Rights, Parents' Rights Poster, Effects of Lead Exposure, car seat poster, menus, and daily schedule. Applicant stated the parents will provide AM/PM snack, and a lunch but the facility will have extras on hand. INDOOR ACTIVITY SPACE: There is one classroom being used for preschool: Classroom #6. LPAs observed a sufficient amount of age- appropriate equipment, toys, tables, and cubbies. There is a first aid kit and medications will be stored in the office. Applicant stated there are no firearms or weapon on the premises. LPAs observed sign in and out sheets. Applicant stated indoor and outdoor drinking water is provided via water bottles brought from home. LPAs observed a functioning smoke and carbon monoxide detector. LPAs observed proof that nap time mats had been ordered and will be arriving shortly.

SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Kelly Ferrara
LICENSING EVALUATOR SIGNATURE:	DATE: 06/24/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2022

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: FOLSOM PREP	FACILITY NUMBER: 343624320
	VISIT DATE: 06/24/2022

NARRATIVE

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LPAs measured the classroom. The total classroom space contains a total of 546.375 square feet, which will accommodate the requested capacity for 15 preschool children. There are 10 toilets, 2 urinals and 10 sinks for the children, and two separate private restrooms for the staff. The same bathrooms will be used for both school age children and the preschool. Applicant understands she must submit a waiver request to share the bathrooms. Children who become ill during the day will be isolated in the office and will use the staff restroom, if necessary. Individual measurements are recorded on the Capacity Worksheet (LIC 9024).

OUTDOOR ACTIVITY SPACE:
There is one outdoor area on the property. The outdoor play area is fenced with a wrought iron fence that is at least four feet tall. LPAs observed a sufficient amount of equipment and toys. There are no bodies of water on the premises. There are shaded areas supplied by trees. LPAs observed a play structure in the outdoor area, however there was no label indicating the age group that could use it. LPAs advised that the play structure could not be used for the preschool children.

LPAs used the measurements from the previous pre-licensing inspection on 2/14/2020 for the school age program. The outdoor play area contains a total of 18,863.57 square feet, which will accommodate applicant's request for 15 preschool children. Individual measurements are recorded on the Capacity Worksheet (LIC 9024).

California Code of Regulations, Title 22, Division 12, Section 101538.2 outdoor activity space provided for school-age child care center children shall be physically separated from other children. Applicant understands that she must submit a waiver request to share the outdoor activity space with the private school program and school age program which specifies the rotation schedule for outdoor activity play times.

LPAs 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. LPAs 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.

SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Kelly Ferrara
LICENSING EVALUATOR SIGNATURE:	DATE: 06/24/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2022

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: FOLSOM PREP	FACILITY NUMBER: 343624320
	VISIT DATE: 06/24/2022

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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.

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.

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 was conducted and a copy of the report was given to the applicant.

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

1) Waiver request for shared outdoor playground.

2) Waiver request for shared bathrooms.

3) Pictures of nap time mats in the classroom.

4) Final review by Licensing Program Manager.

SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Kelly Ferrara
LICENSING EVALUATOR SIGNATURE:	DATE: 06/24/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2022

LIC809 (FAS) - (06/04)

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