Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 283009438
Report Date: 06/27/2017
Date Signed: 06/27/2017 02:19:24 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928
FACILITY NAME:LITTLE BACKPACKS PRESCHOOLFACILITY NUMBER:
283009438
ADMINISTRATOR:KEENER, KATIEFACILITY TYPE:
850
ADDRESS:995 ADAMS STREETTELEPHONE:
(707) 759-4793
CITY:ST. HELENASTATE: CAZIP CODE:
94574
CAPACITY:50CENSUS: 0DATE:
06/27/2017
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
11:20 AM
MET WITH:Katie KeenerTIME COMPLETED:
12:50 PM
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LPA's Kevin O'Connell & Denise Villaflor-Samson made an inspection for the purpose of a change of ownership from previous facility number 283004402 located at the same, previous location. Katie has been the director of this facility or about three and a half years. The requested capacity is 50 and has been 50 under the previous owner. Fire Marshall approval was received. No children present as they are closed for the week.
This building houses this preschool license and infant license 283009437. The preschool consists of three separate classrooms and fenced play yards. The Dizzy Dino room (2 & 3 year olds) has 1 toilet and 3 sinks. The Butterfly room (3 & 4 year olds) has 3 toilets & 3 sinks. The Ladybug room (4 & 5 year olds) has 2 toilets & 5 sinks. Toilet paper and paper towels are available to meet the children's needs. Classrooms have furniture and equipment that is age appropriate. Heating, lighting and ventilation is adequate. Drinking water is readily available by drinking both inside and out. There is adequate storage for the children's belongings. There is more than enough square footage to accommodate 50 children. The facility serves snacks both in the morning and afternoon. The children bring their own lunch with names on each. Menus are posted. The director's office will be used as an isolation area for the care of an ill child. Food preparation area is inaccessible to children. Cleaning supplies are inaccessible to children and are stored separately from food. The outdoor play area is inspected. Shade is provided in each yard and fencing is at least 4 feet high around the perimeter of the playground. Playground is free of hazards. There is a working telephone on the premises. First aid supplies are stored in the kitchen and in red bags hung high in each classroom.
At least 1 staff person with current pediatric CPR and First Aid cards and Preventative Health will be present at all times children are in care. Six staff members have preventative health that includes nutrition. IMS- Incidental Medical Services was discussed and information was given. They are not administering any IMS at this time.
There were 4 functioning carbon monoxide detectors a sprinkler system throughout and hard-wired smoke detectors. Posting requirements are met. A copy of the complete regulations is on site. LIS staff records indicate that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.
A license will be issued after :
financial information is verified and approved.
SUPERVISOR'S NAME: Jordan MonathTELEPHONE: (530) 513-1214
LICENSING EVALUATOR NAME: Kevin O'ConnellTELEPHONE: (707) 588-5026
LICENSING EVALUATOR SIGNATURE:

DATE: 06/27/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2017
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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