313623396-12-16-2021-03-CC-ABLI-C9RQQ6-20211216112149

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 313623396
Report Date: 12/16/2021
Date Signed: 12/16/2021 11:22:15 AM

Document Has Been Signed on 12/16/2021 11:22 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME:	GUIDING STARS ACADEMY		FACILITY NUMBER:	313623396
ADMINISTRATOR:	SHEPARD, MALLORY		FACILITY TYPE:	850
ADDRESS:	595 A STREET		TELEPHONE:	(916) 645-1099
CITY:	LINCOLN	STATE: CA	ZIP CODE:	95648
CAPACITY: 30	TOTAL ENROLLED CHILDREN: 30	CENSUS: 21	DATE:	12/16/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:15 AM
MET WITH:	Mallory Shepard		TIME COMPLETED:	12:00 PM

NARRATIVE

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All times on this report are approximations. At 8:15 a.m. Licensing Program Analyst (LPA) Amanda Blesi met with assistant Director, Amber Williams, for the purpose of an unannounced 1 year required inspection. Director Mallory Shepard arrived shortly after. Operating hours of the facility are from 7:00 a.m.-6:00 p.m., Monday thru Friday. LPA toured the facility, at which time a census of 21 preschool children supervised by 4 staff was observed. All individuals subject to criminal background review have obtained criminal record clearance.

A health and safety inspection was conducted in the classrooms, restrooms, food service areas, and outdoor play areas. LPA observed the following documents are posted: License, Emergency Disaster Plan, Personal Rights, Parents' Rights Poster, menus, and daily schedule. Cleaning disinfectants and hazardous items are appropriately stored and inaccessible to children. Medications are stored, inaccessible to children. Furniture and equipment are in good condition, and toileting facilities are in sanitary. Bins for solid waste in the kitchen have tight fitting lids. The floors appeared clean throughout the facility. Menus were posted.

There are functional water fountains indoors and outdoors. Children also have labeled water bottles. LPA observed full legal signatures while reviewing the sign in and sign out sheet. Playground equipment and surfaces are free of loose or sharp parts. LPA observed wood chip cushioning beneath the play structure. Outdoor shade is provided by trees and awnings. There are no firearms or bodies of water on the premises. LPA observed a functional carbon monoxide detector.

At 9:30am LPA reviewed staff files. At least one staff member present today has current Pediatric CPR and First Aid certification. LPA observed immunization records and documentation of the educational background, training, and/or experience. LPA observed updated AB 1207 Mandated Reporter training certificates. Director was advised that Mandated Reporter training must be renewed every two years and can be renewed at www.mandatedreporterca.com. (Report continues on 809-C)

SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Amanda Blesi
LICENSING EVALUATOR SIGNATURE:	DATE: 12/16/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2021

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, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: GUIDING STARS ACADEMY	FACILITY NUMBER: 313623396
	VISIT DATE: 12/16/2021

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At 10am LPA reviewed children's records. Each child's file contained an emergency card, consent for emergency medical treatment, health history and notifications of children’s and parent’s rights.

Facility representative 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.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s personnel, and administrative records. For IMS information see Evaluator Manual-Regulation Interpretations and Procedures for Child Care Center Sections 101173 and 101226. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 513-0301 (voice)/(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.ht

LPA discussed Assembly Bill 2370, which will require licensed Child Care facilities to test their water for excessive amounts of lead. Testing will be required beginning January 1st, 2020 to January 1st, 2023 and must be conducted every five years from initial testing.

Director was encouraged to the visit the Department's website at WWW.CDSS.CA.GOV for information regarding child care updates, forms, regulations and legislation pertaining child care centers.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with Mallory Shepard.

Title 22 deficiencies are sited on the subsequent page of this report. See LIC 809-D. Appeal Rights given.

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

SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Amanda Blesi
LICENSING EVALUATOR SIGNATURE:	DATE: 12/16/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2021

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 12/16/2021 11:22 AM - It Cannot Be Edited

Created By: Amanda Blesi On 12/16/2021 at 10:53 AM

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
, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: GUIDING STARS ACADEMY	FACILITY NUMBER: 313623396
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 12/16/2021

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101238(a)

Buildings and Grounds

(a) The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation LPA observed four toilets in the children's bathrooms. Two of the four toilets were not working. If not corrected, this could pose a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 01/06/2022
	Plan of Correction
1 2 3 4	Director contacted a plumber on 12.15.21 and is waiting for the repair of the two toilets. To correct this deficiency, director shall send proof of correction that the toilets have been fixed. This shall be sent to LPA by plan of correction date of 1.06.2022.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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:

Keven Peters

LICENSING EVALUATOR NAME:

Amanda Blesi

LICENSING EVALUATOR SIGNATURE:

DATE: 12/16/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2021

LIC809 (FAS) - (06/04)

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