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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 233010489
Report Date: 08/31/2023
Date Signed: 08/31/2023 12:34:50 PM

Document Has Been Signed on 08/31/2023 12:34 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, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:SHANEL VALLEY ACADEMYFACILITY NUMBER:
233010489
ADMINISTRATOR:JACINTO, LINDAFACILITY TYPE:
850
ADDRESS:1 RALPH BETTCHER DRIVETELEPHONE:
(707) 744-1485
CITY:HOPLANDSTATE: CAZIP CODE:
95449
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: DATE:
08/31/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Linda JacintoTIME COMPLETED:
12:45 PM
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Licensing Program Analyst (LPA) Glenn Ouye met with Director Linda Jacinto to conduct the prelicensing inspection of the Shanel Valley Academy Early Learning Center. The application was received on July 18 2023. The applicant is seeking a license for 24 preschool children. The fire clearance was approved on August 16, 2023.

The facility is a single classroom at the Shanel Valley Academy Elementary School. There are two bathroom. Each has a toilet and sink. There is also an additional sink in the classroom. There is a separate staff bathroom and a staff office. There are sufficient furniture, equipment and toys for the children. There is a functioning smoke/carbon monoxide detector and fire extinguishers are each exit door. The first aid supplies are required to be maintained at all times. The facility has a backpack with first aid supplies. There is sufficient square footage for the requested capacity.

The outdoor activity area also has sufficient square footage for the requested capacity. The outdoor activity area has a large play area with wood chips for fall protection. There is also a shaded area over the sand box. Outdoor hydration will be achieved with individual reusable cups for each child.

The facility will be responsible to conduct water lead testing within six months of licensure. Information about the lead test water samplers and the PIN regarding the requirement for lead water testing was provided to the applicant.

The Applicant was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, 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.
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Glenn Ouye
LICENSING EVALUATOR SIGNATURE: DATE: 08/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/31/2023
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, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: SHANEL VALLEY ACADEMY
FACILITY NUMBER: 233010489
VISIT DATE: 08/31/2023
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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, available at: http://www.ada.gov/childqanda.htm

LPA reviewed with applicant, the LIC 311A, Records to Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted.

Applicant, was informed of the MyChildCarePlan.org site, 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.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

A notice of site visit will always be provided to a facility representative except for the prelicensing visit and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

The license for the Shanel Valley Academy Early Learning Center is approved effective August 31, 2023.

Exit interview conducted and report was reviewed with the applicant, Linda Jacinto, Director., .
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Glenn Ouye
LICENSING EVALUATOR SIGNATURE:

DATE: 08/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2023
LIC809 (FAS) - (06/04)
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