406212971-7-25-2024-17-CC-EBAY-D7HRK6-20240725130502

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 406212971
Report Date: 07/25/2024
Date Signed: 07/25/2024 01:05:08 PM

Document Has Been Signed on 07/25/2024 01:05 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, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME:	KIDZ KORNER PRESCHOOL		FACILITY NUMBER:	406212971
ADMINISTRATOR/ DIRECTOR:	CAMILLE BRUNNER		FACILITY TYPE:	850
ADDRESS:	3396 JOHNSON AVE.		TELEPHONE:	(805) 544-5194
CITY:	SAN LUIS OBISPO	STATE: CA	ZIP CODE:	93401
CAPACITY: 60	TOTAL ENROLLED CHILDREN: 60	CENSUS: 13	DATE:	07/25/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:30 AM
MET WITH:	Camille Brunner		TIME VISIT/ INSPECTION COMPLETED:	01:15 PM

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On 7/25/24, at 9:30 AM, Licensing Program Analyst (LPA) Elvin Baddley conducted an unannounced Annual Random Inspection the abovementioned Child Care Center (CCC). LPA met with Camille Brunner, Director of the CCC and explained the purpose of the inspection. LPA, in the company of Director, toured the interior and exterior of the CCC. The CCC operates from 7:45 AM to 5:15 PM, Monday - Friday. The CCC is on the grounds of the Church of the Nazarene in San Luis Obispo. Additionally, the CCC is a preschool program with a toddler option. The CCC maintains three classrooms, however only two are in use given the population of children in care as well as the present staff members. The classrooms used are Classroom 1- Firefly Room, ages 3 to 4 years and Classroom 6- the Caterpillar Room, ages 2 to 3 years. LPA observed 13 children on site along with 3 teachers (cleared and associated) providing care and supervision. LPA also notes the Director assist with care and supervision of the children.

All classrooms of the CCC were clean and organized. The classrooms have age appropriate toys and furnishings available for children in care. The classrooms have combination carbon monoxide/smoke detectors. LPA tested a combination carbon monoxide/smoke detector at 10:18 AM in Classroom 1 which was found to be operable. The restrooms of the CCC used by children in care are observed in safe and sanitary operating condition. LPA observed operable refrigerators in each classroom which contained children's lunches. LPA notes snacks are provided by the CCC, while children in care bring lunches from their homes. There is available drinking water for children both inside the classroom and outside in the play area. CCCs constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1- CCP). LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP. LPA reviewed posted menu in the classrooms while licensing required notices and documents are posted near the entry of each classroom. LPA observed sign In/out forms in the outdoor area outside the classrooms.

(CONT. 809-C, Page 2)

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE:	DATE: 07/25/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/25/2024

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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Document Has Been Signed on 07/25/2024 01:05 PM - It Cannot Be Edited

Created By: Elvin Baddley On 07/25/2024 at 11:43 AM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: KIDZ KORNER PRESCHOOL	FACILITY NUMBER: 406212971
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/25/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation/interview/record review, the licensee did not comply with the section cited above in that S1 and S2 did not have current Mandated Reporter certifications, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 08/08/2024
	Plan of Correction
1 2 3 4	CCC Director to provided CCLD (elvin.baddley@dss.ca.gov) current Mandated Reporter certifications for S1 and S2 no later than the closed of business (5:00 PM) on 8/8/24.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME:

Maria Mueller

LICENSING EVALUATOR NAME:

Elvin Baddley

LICENSING EVALUATOR SIGNATURE:

DATE: 07/25/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/25/2024

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
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: KIDZ KORNER PRESCHOOL	FACILITY NUMBER: 406212971
	VISIT DATE: 07/25/2024

NARRATIVE

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LPA reviewed sign in and sign out information and notes the arrival and departure times of children is included along with information from the children's authorized representatives/parents.

Disinfectants and cleaning solutions are observed in secured locations in each classroom which are inaccessible to children in care. Director notes no medication is on site, but when medication is present it is stored in a secure elevated location, which is inaccessible to children in care. Waste receptacles with tight fitting covers are observed throughout the CCC.

The CCC has two outdoor playground areas (courtyard and south end of the CCC). Both are enclosed and the entry/exit gates are secured. LPA observed age appropriate toys and play equipment in each of the the play areas. The toys and play equipment observed are in suitable condition and free of sharp, loose or pointed objects. The play structures in the playground areas have adequate cushioning materials to absorb falls and an abundance of shade. LPA reminded Director to replace outdoor play equipment when such equipment begins to degrade or is not in good repair. No bodies of water are observed on site.

A sampling of staff and children's records are reviewed. The children’s records were complete and found to contain emergency contact information as well as immunization records, among other required licensing documents. At 11:25 AM, LPA reviewed staff records. LPA was unable to find currently Mandated Reporter certifications for S1 and S2. Aside form the aforementioned, staff records were current and complete. LPA notes CCC record indicate the last fire drill was on 7/25/24. Director informed LPA no firearm or ammunition is stored on site.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of “medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. 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 are available at: https://www.ada.gov/resources/child-care-centers/.

Facility representative was reminded that all adults 18 and over, 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 (CONT. 809, Page 3)

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE:	DATE: 07/25/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/25/2024

LIC809 (FAS) - (06/04)

Page: 3 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: KIDZ KORNER PRESCHOOL	FACILITY NUMBER: 406212971
	VISIT DATE: 07/25/2024

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maximum of 30 days per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with Facility representative 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. LPA also informed facility representative 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.

Facility representative was informed of the MyChildCarePlan.org website; 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.

A Type B Deficiency is being cited based on LPAs' observation/interviews/record reviews pursuant to Title 22 of the CA Code of Regulations and HSC 1596.8662 (refer to LIC 809-D). Licensee was provided a copy of their Appeal Rights (LIC 9058) and their signature on this form acknowledges receipt of these rights.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Facility representative Camille Brunner.

Duration of the inspection extended due to computer malfunction.

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE:	DATE: 07/25/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/25/2024

LIC809 (FAS) - (06/04)

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