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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343621719
Report Date: 06/06/2024
Date Signed: 06/06/2024 10:28:19 AM

Document Has Been Signed on 06/06/2024 10:28 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:VINELAND PRESCHOOLFACILITY NUMBER:
343621719
ADMINISTRATOR/
DIRECTOR:		NICOLE SCHLIEFACILITY TYPE:
850
ADDRESS:6450 20TH STREETTELEPHONE:
(916) 566-1616
CITY:RIO LINDASTATE: CAZIP CODE:
95673
CAPACITY: 30TOTAL ENROLLED CHILDREN: 30CENSUS: 6DATE:
06/06/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:50 AM
MET WITH:Reem ZidanTIME VISIT/
INSPECTION COMPLETED:
10:45 AM
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On June 6, 2024, Licensing Program Analyst (LPA) Lea Habotm arrived to the facility located on the campus of Vineland Preschool. LPA stated the purpose of the inspection today was for a required 1-year inspection. There were 6 children being supervised by the site supervisor and 2 staff members. Reem Zidan, District Office Site Supervisor, arrived during the inspection to assist. The preschool is located in a portable which is divided into two classrooms: the rectangle room and the triangle room. Facility hours of operation are Monday – Friday 7:00am to 5:00pm. Children's lunches and snacks are delivered from the school cafeteria.

LPA toured both classrooms, restrooms, and outdoor play areas. LPA reviewed care and supervision of children, staffing ratios, health related services, furniture, equipment, and drinking water. There are two playgrounds for preschool use, with trees that provide shade and children use their own water bottles. LPA reviewed the children's Identification and Emergency Information. LPA reviewed personnel's education and immunization requirements. All staff have fingerprint clearances and associations with Twin Rivers School District or in guardian under Madison Elementary School facility number 343615667. At least one staff member present today has current EMSA approved Pediatric/Child CPR and First Aid and all staff members have current mandated reporter training certificates.

Report continued on 809-C
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Lea Habtom
LICENSING EVALUATOR SIGNATURE: DATE: 06/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/06/2024
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: VINELAND PRESCHOOL
FACILITY NUMBER: 343621719
VISIT DATE: 06/06/2024
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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.html

Fees are current. LPA provided the Community Care Licensing website www.ccld.ca.gov, so the director can obtain updated licensing information, new regulations and access forms. LPA advised director of their responsibility to stay current in regards to new regulations. LPA also included the email address for the children's advocacy program to stay current on new laws childcareadvocatesprogram@dss.ca.gov.

There are no Title 22 deficiencies cited during today's inspection.

Exit interview conducted and report was reviewed with the facility representative Reem Zidan. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.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: Lea Habtom
LICENSING EVALUATOR SIGNATURE:

DATE: 06/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

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