Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 283009438
Report Date: 07/03/2019
Date Signed: 07/03/2019 01:57:55 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA
FACILITY NAME:LITTLE BACKPACKS PRESCHOOLFACILITY NUMBER:
283009438
ADMINISTRATOR:KEENER, KATIEFACILITY TYPE:
850
ADDRESS:995 ADAMS STREETTELEPHONE:
(707) 963-4705
CITY:ST. HELENASTATE: CAZIP CODE:
94574
CAPACITY:50CENSUS: 19DATE:
07/03/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:10 PM
MET WITH:Anna Saldana, Assistant DirectorTIME COMPLETED:
02:12 PM
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A annual inspection was made to the facility by Licensing Program Analyst (LPA) Kevin O'Connell. The facility file was reviewed prior to this visit. A review of the personnel report on 7/03/19 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.
This program operates Monday - Friday; 7:30 am to 5:30 pm. The facility was toured with the Assistant Director at 12:20pm and the floor and yard plan submitted by the licensee were verified. This facility is licensed for 50 children. Four staff were supervising 19 children during today's inspection and were operating within the licensed capacity and ratio requirements.
The items which could pose a danger to children (such as detergents, cleaning compounds and medications) were observed to be inaccessible to children. There are currently no poisons on the premises but they know to lock them if need be. The toys, floors, desks and other equipment and surfaces are clean, toxic free, safe and in good condition. There is uncontaminated drinking water available to children both indoors and outdoors on the playground. The children's bathrooms are in safe and sanitary condition. Food prep areas are clean. Food is properly stored and refrigerated as needed. Snacks are provided. Menus were posted. Garbage containers containing solid waste have tight fitting lids. The LPA observed a working carbon monoxide detector and there were charged fire extinguishers of at least 2A 10: BC or larger.
The playground was free of hazards. The playground equipment was in safe condition. There are wood chips for cushioning underneath climbing structures and/or play equipment to absorb falls. The Assistant Director stated that there are no bodies of water and none were observed. The Assistant Director stated no weapons are stored on site and none were observed. Staff possessed current Pediatric CPR and First Aid certifications.
SUPERVISOR'S NAME: Leslie LeporiTELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Kevin O'ConnellTELEPHONE: (707) 588-5026
LICENSING EVALUATOR SIGNATURE:

DATE: 07/03/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA
FACILITY NAME: LITTLE BACKPACKS PRESCHOOL
FACILITY NUMBER: 283009438
VISIT DATE: 07/03/2019
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The sign-in/sign-out procedure was reviewed and in compliance. Ten children’s records were reviewed at 12:35pm, and contained signed admission agreements. Four staff records were reviewed at 12:50pm and contained immunizations, Mandated Reporter Certificates and documentation of education.
Incidental Medical Services (IMS) policy was discussed. This facility is not providing any IMS at this time. 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: and the ADA, available at: http://www.ada.gov/childqanda.htm

This report, as well as the AAP Guide to Safe Sleep, Safe Sleep in Childcare brochure, What does a Safe Sleep Environment Look Like brochure & Safe Sleep Concepts handout, were reviewed and discussed with the Assistant Director. The Effects of Lead Exposure brochure has been reviewed with and discussed with the Assistant Director. All licensing reports are public information and must be made available upon request for at least three years.
Notice of Site Visit shall be posted for 30 days from today's visit.

There were no Title 22 deficiencies cited during today's inspection.
SUPERVISOR'S NAME: Leslie LeporiTELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Kevin O'ConnellTELEPHONE: (707) 588-5026
LICENSING EVALUATOR SIGNATURE:

DATE: 07/03/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2019
LIC809 (FAS) - (06/04)
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