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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 455406526
Report Date: 04/24/2023
Date Signed: 08/23/2023 09:25:45 AM

Document Has Been Signed on 08/23/2023 09:25 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
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME:KIDS & ME PRESCHOOLFACILITY NUMBER:
455406526
ADMINISTRATOR:PEREZ, ROBINFACILITY TYPE:
850
ADDRESS:3695 CHURN CREEK RD.TELEPHONE:
(530) 222-3525
CITY:REDDINGSTATE: CAZIP CODE:
96002
CAPACITY: 72TOTAL ENROLLED CHILDREN: 75CENSUS: 48DATE:
04/24/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Robin PerezTIME COMPLETED:
04:15 PM
NARRATIVE
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On 2/4/2023 at 1:00pm, a Required 1-Year inspection was made to the facility by Licensing Program Analyst (LPA), Laura Chavez. The facility operates 7:00am-5:30pm, Monday–Friday. The facility was toured at 12:15pm inside and outside and the floor and yard plan submitted by the licensee were verified.

Four teachers and three aides were supervising 48 children, and operating within the licensed capacity and ratio requirements.

Five children's records were reviewed at 1:15pm. A review of children's records found C1 is missing a signed Personal Rights. C2 is missing a physicians report. C3 is missing TB test results as well as the Physicians Report. C4 is missing TB test results as well as the Consent for Medical Attention.

Director Perez stated the water used for drinking water and food preparation has not been tested for lead contamination.

Five staff records were reviewed at 2:10pm. A review of staff records found S1, S2,S3, and S4 are missing proof of immunization's for Pertussis and Measles. S3, S4 and S5 are missing TB test results. Proof of Current Mandated Reporter Training is missing for S1 thru S5. S2, S3 and S5 are missing Health Screenings. S3 and S4 are missing transcripts and or proof to show they are qualified teachers.

A review of the facilities sign-in and sign-out sheet found that 2 of the 48 children in care were not signed by the persons bringing the children to the facility.

Report continued: See 809-C

SUPERVISORS NAME: Megan Aviles
LICENSING EVALUATOR NAME: Laura Chavez
LICENSING EVALUATOR SIGNATURE: DATE: 04/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/24/2023
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
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME: KIDS & ME PRESCHOOL
FACILITY NUMBER: 455406526
VISIT DATE: 04/24/2023
NARRATIVE
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here are no pools or bodies of water on the premises. The outdoor activity space was cushioned with wood chips and free of hazards.

The Director 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.

Incidental Medical Services (IMS) policy was discussed. 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

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. An exit interview conducted and report was reviewed with Director Robin Perez. Director Perez was informed that a continued inspection will be completed on a later date.

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.

SUPERVISORS NAME: Megan Aviles
LICENSING EVALUATOR NAME: Laura Chavez
LICENSING EVALUATOR SIGNATURE:

DATE: 04/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2023
LIC809 (FAS) - (06/04)
Page: 2 of 7
Document Has Been Signed on 08/23/2023 09:25 AM - It Cannot Be Edited


Created By: Laura Chavez On 05/25/2023 at 08:07 PM
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
, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME: KIDS & ME PRESCHOOL
FACILITY NUMBER: 455406526

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/24/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.16(a)(1)
Lead Testing
(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on an interview, the licensee did not comply with the section cited above which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/24/2023
Plan of Correction
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2
3
4
Facility Director agrees to have faucets tested for lead that provides drinking water and water used for food prep. The plan of correction shall be submitted to CCLD on or before 5/24/2023.
Type B
Section Cited
HSC
1596.7995(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on staff file reviews, the licensee did not comply with the section cited above in 5 out of 5 staff file reviews which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/24/2023
Plan of Correction
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2
3
4
Facility Director agrees to provide proof of Staff 1-5 of being immunized against influenza, pertussis, and measles. The plan of correction shall be submitted to CCLD on or before 5/24/2023.
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:Megan Aviles
LICENSING EVALUATOR NAME:Laura Chavez
LICENSING EVALUATOR SIGNATURE:
DATE: 05/26/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/26/2023


LIC809 (FAS) - (06/04)
Page: 3 of 7
Document Has Been Signed on 08/23/2023 09:25 AM - It Cannot Be Edited


Created By: Laura Chavez On 05/25/2023 at 08:07 PM
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
, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME: KIDS & ME PRESCHOOL
FACILITY NUMBER: 455406526

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/24/2023

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 record reviews, the licensee did not comply with the section cited above in 6 out of 6 staff file reviews which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/24/2023
Plan of Correction
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2
3
4
Facility Director agrees to provide copies of certificates of Staff 1, 2, 3, 4, and 6 completing the required Mandated Reporter Training. The plan of correction shall be submitted to CCLD on or before 5/24/2023.
Type B
Section Cited
CCR
101216(g)(1)
Personnel Requirements
(1) Except as specified in (3) below, good physical health shall be verified by a health screening, including a test for tuberculosis, performed by or under the supervision of a physician not more than one year prior to or seven days after employment or licensure.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record reviews, the licensee did not comply with the section cited above which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/24/2023
Plan of Correction
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2
3
4
The Director agrees to provide copies of Health Screenings for Staff 2, 3, and 5. The plan of correction shall be submitted to CCLD on or before 5/24/2023.
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:Megan Aviles
LICENSING EVALUATOR NAME:Laura Chavez
LICENSING EVALUATOR SIGNATURE:
DATE: 05/26/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/26/2023


LIC809 (FAS) - (06/04)
Page: 4 of 7
Document Has Been Signed on 08/23/2023 09:25 AM - It Cannot Be Edited


Created By: Laura Chavez On 05/25/2023 at 08:07 PM
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
, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME: KIDS & ME PRESCHOOL
FACILITY NUMBER: 455406526

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/24/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101216.1(g)
Teacher Qualifications and Duties
(g) A photocopy of the teacher's Child Development Permit as specified in (c)(3) above, or a photocopy of the teacher's transcript(s) documenting successful completion of required course work, shall be maintained at the center.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record reviews, the licensee did not comply with the section cited above in 2 out of 6 staff file reviews which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/24/2023
Plan of Correction
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2
3
4
Facility Director agrees to provide copies of transcripts for Staff 3 and 4 documenting completion of required course work.
The plan of correction shall be submitted to CCLD on or before 5/24/2023.
Type B
Section Cited
CCR
101217(a)(12)
Personnel Records
(a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information: (12) Tuberculosis test documents as specified in Section 101216(g).

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record reviews, the licensee did not comply with the section cited above in 3 out of 5 staff file reviews which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/24/2023
Plan of Correction
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2
3
4
Facility Director agrees to provide copies of TB test results for staff 3, 4, and 5. The plan of correction shall be submitted to CCLD on or before 5/24/2023.
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:Megan Aviles
LICENSING EVALUATOR NAME:Laura Chavez
LICENSING EVALUATOR SIGNATURE:
DATE: 05/26/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/26/2023


LIC809 (FAS) - (06/04)
Page: 5 of 7
Document Has Been Signed on 08/23/2023 09:25 AM - It Cannot Be Edited


Created By: Laura Chavez On 05/25/2023 at 08:08 PM
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
, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME: KIDS & ME PRESCHOOL
FACILITY NUMBER: 455406526

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/24/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101220(a)
Child's Medical Assessments
(a) Prior to, or within 30 calendar days following the enrollment of a child, the licensee shall obtain a written medical assessment of the child. This medical assessment enables the licensee to assess whether the center can provide necessary health-related services to the child.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record reviews, the licensee did not comply with the section cited above in 2 out of 5 children's file reviews which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/24/2023
Plan of Correction
1
2
3
4
The facility Director agrees to provide copies of Child 2 and 4 physician reports. The plan of correction shall be submitted to CCLD on or before 5/24/2023.
Section Cited
Child's Medical Assessments
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:Megan Aviles
LICENSING EVALUATOR NAME:Laura Chavez
LICENSING EVALUATOR SIGNATURE:
DATE: 05/26/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/26/2023


LIC809 (FAS) - (06/04)
Page: 6 of 7
Document Has Been Signed on 08/23/2023 09:25 AM - It Cannot Be Edited


Created By: Laura Chavez On 05/25/2023 at 08:08 PM
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
, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME: KIDS & ME PRESCHOOL
FACILITY NUMBER: 455406526

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/24/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101223(b)(1)
Personal Rights
(1) The center shall give each authorized representative a copy of the Personal Rights form (LIC 613A [9/96]).

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record reviews, the licensee did not comply with the section cited above in 1 out of 5 child file reviews which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/24/2023
Plan of Correction
1
2
3
4
The facility Director agrees to provide a copy of Child #1's completed Personal Rights. The plan of correction shall be submitted to CCLD on or before 5/24/2023.
Type B
Section Cited
CCR
101229.1(b)
Sign In and Sign Out
(b) The person who brings the child to, and removes the child from, the center shall sign the child in/out.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on a review of the facilities sign-in and sign-out sheet found that 2 of the 48 children in care were not signed by the person(s) bringing the children to the facility which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/24/2023
Plan of Correction
1
2
3
4
The facility Director agrees to provide a written statement on how she will ensure that all persons dropping off and picking up children from the facility will sign them in and out. The plan of correction shall be submitted to CCLD on or before 5/24/2023.
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:Megan Aviles
LICENSING EVALUATOR NAME:Laura Chavez
LICENSING EVALUATOR SIGNATURE:
DATE: 05/26/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/26/2023


LIC809 (FAS) - (06/04)
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