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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 093621377
Report Date: 11/19/2024
Date Signed: 11/19/2024 11:39:14 AM

Document Has Been Signed on 11/19/2024 11:39 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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:PIONEER UNION SCHOOL DISTRICTFACILITY NUMBER:
093621377
ADMINISTRATOR/
DIRECTOR:
PIONEER UNION SDFACILITY TYPE:
850
ADDRESS:6860 MT AUKUM ROADTELEPHONE:
(530) 620-3556
CITY:SOMERSETSTATE: CAZIP CODE:
95684
CAPACITY: 16TOTAL ENROLLED CHILDREN: 16CENSUS: 13DATE:
11/19/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:45 AM
MET WITH:Michele MeltonTIME VISIT/
INSPECTION COMPLETED:
11:55 AM
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On November 19, 2024, Licensing Program Analyst (LPA) Soleil Marx, met with Facility Representative, Michele Melton, for an unannounced annual inspection. Facility hours of operation are Monday through Friday, 08:30 AM to 02:50 PM. This facility is located on the Pioneer Elementary premises in classroom F1 and has a shared space waiver for restroom and playground space.

LPA observed facility was in compliance with ratio requirements which included a census of 13 preschool age children being supervised by two staff. Facility Representative was reminded never to exceed the conditions, limitations and capacity specified on the license.

LPA inspected all areas accessible to children including indoor activity spaces, restrooms, food service areas, and outdoor play areas. LPA observed that hazardous items including detergents, cleaning compounds, medication, sharp utensils, and other items that could pose a danger to children in care, are properly stored out of children's reach. The floors appeared clean throughout the facility. Furniture and equipment were in good condition. LPA observed a variety of age appropriate activities and materials for children to utilize. LPA observed medications are stored in a central location and there was an ample amount of first aid supplies available. LPA observed a 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. Toileting facilities were in sanitary, well stocked, and in 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. Food is prepared in the elementary school kitchen and delivered to the classroom. Uncontaminated drinking water was readily available to children both indoors and outdoors. Outdoor activity space and equipment appeared in good repair and free of loose or sharp parts. LPA observed adequate cushioning in areas underneath climbing equipment via woodchips and shaded areas provided. There are no bodies of water on the premises.

LPA observed documents to be posted. LPA observed a current children's roster and fire drill log within the facility, last drill was conducted October of 2024. LPA observed required licensing documents were posted and visible to authorized representatives.

SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Soleil Marx
LICENSING EVALUATOR SIGNATURE: DATE: 11/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/19/2024
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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: PIONEER UNION SCHOOL DISTRICT
FACILITY NUMBER: 093621377
VISIT DATE: 11/19/2024
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LPA reviewed facility records including child's records, personnel records, administrative records. LPA reviewed a sample of children’s files and observed that each child's file contained the required licensing documentation. LPA reviewed records for all present staff. At least one staff member present today has current Pediatric CPR and First Aid certification expiring 09/2025. 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.

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.

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.

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, LPA observed the facility to be in compliance with Title 5 and Title 22 regulations. No deficiencies were cited. Exit interview conducted and report was reviewed with the Facility Representative. 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: 11/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/19/2024
LIC809 (FAS) - (06/04)
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