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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 093604118
Report Date: 01/18/2024
Date Signed: 01/18/2024 01:20:23 PM

Document Has Been Signed on 01/18/2024 01:20 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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:HEAVENLY SKI RESORTFACILITY NUMBER:
093604118
ADMINISTRATOR:SIMSPSON, CASSIDYFACILITY TYPE:
850
ADDRESS:3860 SADDLE ROADTELEPHONE:
(530) 542-6912
CITY:SOUTH LAKE TAHOESTATE: CAZIP CODE:
96150
CAPACITY: 32TOTAL ENROLLED CHILDREN: 32CENSUS: 8DATE:
01/18/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Cassidy ArnoldTIME COMPLETED:
01:45 PM
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Licensing Program Analysts (LPAs) Soleil Marx and Amanda Sutter, met with Facility Representative, Cassidy Arnold, for an unannounced annual inspection. LPAs observed a census of eight preschool age being supervised by two staff. Facility Representative was reminded never to exceed the conditions, limitations and capacity specified on the license. All individuals subject to criminal background review have obtained a criminal record clearance. Facility hours of operation are 7 days a week from 08:00AM to 05:00PM, during the winter season.

LPAs inspected all activity and classroom spaces, restrooms, food service, and both indoor and outdoor play areas. Hazardous items were inaccessible to children. The floors appeared clean throughout the facility. Furniture and equipment were in safe, operable condition. Outdoor activity space and equipment were in good repair and free of loose or sharp parts. Toileting facilities were in safe, sanitary, and operating condition. Food preparation space was hygienic, and all food protected against contamination. Menus were posted for AM/PM snack and lunch, which is provided by the facility. Uncontaminated drinking water was readily available to children both indoors and outdoors. Trash bins have tight-fitting lids. LPAs observed medications were stored in a central location and an ample amount of first aid supplies available. LPAs observed a functional carbon monoxide detector, smoke detector, and fully charged 2A10BC fire extinguisher within the facility. LPA observed authorized representatives are using full legal signatures on the sign in and out sheet. There are no bodies of water on the premises.

LPAs reviewed facility records including child's records, personnel records, administrative records, and documents to be posted. LPAs reviewed a sample of children’s files and observed that each child's file contained the required licensing documentation. Facility has a medical assessment waiver due to drop in care. LPAs reviewed records for all staff. At least one staff member present today has current Pediatric CPR and First Aid certification expiring 03/2024. All staff currently employed with the facility have: a criminal record clearance, a health screening report, immunization records, current AB1207 Mandated Reporter Training, and documentation of their educational background, training, and/or experience. LPAs observed a children's roster and fire drill log within the facility. LPAs observed all required licensing documents were posted and visible to authorized representatives.

SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Soleil Marx
LICENSING EVALUATOR SIGNATURE: DATE: 01/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/18/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: HEAVENLY SKI RESORT
FACILITY NUMBER: 093604118
VISIT DATE: 01/18/2024
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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 maximum of 30 days per person will be assessed if this regulation is violated.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (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 referred facility representative to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.CCC COMPLETED TESTING.

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 are available at: https://www.ada.gov/resources/child-care-centers/.

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.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

Based on today’s inspection Title 22 deficiencies are being cited on 809-D.

Exit interview conducted and report was reviewed with the Facility Representative, Cassidy Arnold. A notice of site visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Soleil Marx
LICENSING EVALUATOR SIGNATURE:

DATE: 01/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/18/2024
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Document Has Been Signed on 01/18/2024 01:20 PM - It Cannot Be Edited


Created By: Soleil Marx On 01/18/2024 at 12:51 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
, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: HEAVENLY SKI RESORT
FACILITY NUMBER: 093604118

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/18/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101221(b)(8)(C)
Child's Records
(C) A signed consent form for emergency medical treatment unless the child's authorized
representative has signed the statement specified in Section 101220(f).

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above by not having a signed consent for emergency medical treatment in 3 out of 3 childrens files, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/16/2024
Plan of Correction
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Facility Representative will have authorized representatives sign consent for medical treatment and submit to LPA Marx by POC due date.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Natalie Dunaway
LICENSING EVALUATOR NAME:Soleil Marx
LICENSING EVALUATOR SIGNATURE:
DATE: 01/18/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/18/2024


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