493010425-7-10-2023-01-CC-GOUE-CTLQJF-20230710121240

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 493010425
Report Date: 07/10/2023
Date Signed: 07/10/2023 12:12:46 PM

Document Has Been Signed on 07/10/2023 12:12 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, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

FACILITY NAME:	PLEASANT HILL CHRISTIAN PRESCHOOL		FACILITY NUMBER:	493010425
ADMINISTRATOR:	CONRRIQUE, RACHEL		FACILITY TYPE:	850
ADDRESS:	1782 PLEASANT HILL ROAD		TELEPHONE:	(707) 823-5868
CITY:	SEBASTOPOL	STATE: CA	ZIP CODE:	95472
CAPACITY: 15	TOTAL ENROLLED CHILDREN: 15	CENSUS:	DATE:	07/10/2023
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Rachel Conrrique		TIME COMPLETED:	12:30 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 Analyst (LPA) Glenn Ouye met with Rachel Conrrique to conduct a prelicensing inspection of the Pleasant Hill Christian Preschool. The application for 15 preschoolers was received on April 27, 2023. The approved fire clearance was granted on June 14, 2023. The facility has two classrooms. There is sufficient furniture, equipment and toys for the children in care. There is one toilet and three sinks (one sink is located in the playground) for the children in care. The are sufficient cots for the children to nap. There are functional smoke and carbon monoxide detectors and two fire extinguisher. There are two fire alarm pull stations located near the exit doors. The first aid kit is located in the bathroom. The outdoor area has sufficient square footage to meet the needs of the 15 preschoolers. The climbing structures have sufficient fall protection. There is sufficient shade from the covered awning and a large tree. Outdoor hydration will be achieved with refillable individual water bottles. The director 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. 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 LPA reviewed with the director the LIC 311A, Records to Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted.

SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Glenn Ouye
LICENSING EVALUATOR SIGNATURE:	DATE: 07/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2023

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, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

FACILITY NAME: PLEASANT HILL CHRISTIAN PRESCHOOL	FACILITY NUMBER: 493010425
	VISIT DATE: 07/10/2023

NARRATIVE

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The director 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.

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 platforms. 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.

A notice of site visit will be given to a facility representative during all site visits except the prelicensing visit and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

The license for Pleasant Hill Christian Preschool is approved effective July 10, 2023 for 15 preschool children.

Exit interview conducted and report was reviewed with the Director, Rachel Conrrique.

SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Glenn Ouye
LICENSING EVALUATOR SIGNATURE:	DATE: 07/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2023

LIC809 (FAS) - (06/04)

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