213005156-8-19-2022-05-CC-BVAN-CHFVPS-20220819163713

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 213005156
Report Date: 08/19/2022
Date Signed: 08/19/2022 04:37:29 PM

Document Has Been Signed on 08/19/2022 04:37 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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	NOVATO ENRICHMENT CARE-MISS NICKY'S PRESCHOOL		FACILITY NUMBER:	213005156
ADMINISTRATOR:	FLETCHER, NICOLE		FACILITY TYPE:	850
ADDRESS:	360 NOVA ALBION WAY		TELEPHONE:	(415) 479-8980
CITY:	SAN RAFAEL	STATE: CA	ZIP CODE:	94903
CAPACITY: 60	TOTAL ENROLLED CHILDREN: 60	CENSUS: 31	DATE:	08/19/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Karen Beckmann and Nicole Fletcher		TIME COMPLETED:	05:00 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	On August 19, 2022., Licensing Program Analyst (LPA) Van met with lead teacher Karen Beckmann. The inspection's purpose was disclosed, and it was an unannounced mandatory 1-year inspection. Director Nicole Fletcher arrived a moment later. There was five staff supervising 31 preschool children. All personnel have a criminal record clearance on file. The days and operations hours are Monday – Friday, 7:00 am – 6 pm. LPA toured and inspected inside and outside the facility alongside the Director to identify potential health and safety hazards. The facility has proper temperature, with adequate ventilation and lighting. The facility had a working phone, centralized smoke alarm, carbon monoxide detector, and fully charged fire extinguishers. The classrooms are clean and organized, with age-appropriate literature and learning resources for the children. There are no obstacles or hazards on the facility floor or ground surfaces. The furniture and toys are in great condition. Individual cubbies for children's belongings are provided and labeled with the child's name. Each classroom has its own set of child-sized tables and chairs. Sleeping mats/cots are stored appropriately. Per Director, children's sleeping supplies are taken home and washed by families weekly. The children's restrooms were inspected, and all bathroom fixtures are in good working order and have adequate on-site supplies. All toilets and handwashing sinks are in good working condition with proper sanitation. There is a separate staff bathroom. Cleaning supplies, disinfectants, and other chemicals are completely inaccessible to children. All electrical outlets have childproofed covered. All solid waste storage containers within the Center have an appropriate tight-fitting cover. Continued on page 2...

SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE:	DATE: 08/19/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2022

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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: NOVATO ENRICHMENT CARE-MISS NICKY'S PRESCHOOL	FACILITY NUMBER: 213005156
	VISIT DATE: 08/19/2022

NARRATIVE

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All emergency supplies are kept in a secure location. Medications are appropriately labeled and kept out of the reach of children. First aid products are fully stocked and ready for use by children.

The outdoor area is surrounded by high fencing and is clear of debris. The outdoor play structures and toys are observed in good shape. The outdoor has a shaded area for children. All play structures have comfortable padding or small barks to absorb accidental falls. Per Director, the sandbox is inspected daily before children play. Drinking water is available for children indoors and outdoors.

Randomly selected children's and personnel records are reviewed. The facility maintained a complete children's file, including all documents required, such as Health History (LIC702), Identification of Emergency Information (LIC700), Consent for Medical Treatment (LIC627), Notification of Parent's Rights (LIC995), and Immunization Records. All personnel or persons requiring caregiver background checks have gotten criminal records and child abuse index clearances or exemptions. Criminal Record Statements (LIC508), Declaration to Report Suspected Child Abuse (LIC9108), Educational Credentials, Notice of Employee Rights (LIC9052), and Proof of Immunization are all on file for staff. All members of staff have current CPR certification.

According to the Director, the Center conducts quarterly fire and earthquake drills, with the most recent on June 20, 2022. The isolation location for an unwell child is located in the Director's office or the yard, and assigned staff will observe and supervise the child until parents are notified to come and pick up the child.

The Director was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.
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SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE:	DATE: 08/19/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2022

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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: NOVATO ENRICHMENT CARE-MISS NICKY'S PRESCHOOL	FACILITY NUMBER: 213005156
	VISIT DATE: 08/19/2022

NARRATIVE

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The incidental Medical Services (IMS) policy was discussed. 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 the publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

The Director was advised that a one-time General Training is also needed in addition to the AB1207 training that the License holder and any personnel employed are expected to undergo every two years. Training is available online at www.mandaterreporterca.com. In addition, the Director was reminded about pesticide training. On the DPR website, go to www.cdpr.ca.gov/shoolipm/childcare for further information.

LPA encouraged the Director to visit the Licensing website at www.ccld.ca.gov for licensing regulations and new updates. Director can also email at childcareadvocatesprogram@dss.ca.gov and ask for the updates to be added to the email list.

During the inspection, LPA requested an up-to-date Emergency Disaster Plan (LIC 610), Personnel Report (LIC 500), the Designation of Administrative Responsibility (LIC 308), and an updated Mandated Reporter training Certificate, Basic Pest management training Certificate for teachers, and Incidental Medical Services Plan. All documents will be submitted to Licensing by August 31, 2022.

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SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE:	DATE: 08/19/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2022

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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: NOVATO ENRICHMENT CARE-MISS NICKY'S PRESCHOOL	FACILITY NUMBER: 213005156
	VISIT DATE: 08/19/2022

NARRATIVE

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To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.

Today, no deficiencies have been identified. An exit interview took place, and the report was discussed with the Director, Nicole Fletcher. Today's report and notice of site visit were provided to the Director. LPA instructed the Director that the site visit notice had to be posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE:	DATE: 08/19/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2022

LIC809 (FAS) - (06/04)

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