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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 390307976
Report Date: 05/10/2023
Date Signed: 05/10/2023 02:51:33 PM

Document Has Been Signed on 05/10/2023 02:51 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, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME:WEST VALLEY CHRISTIAN ACADEMY PRESCHOOLFACILITY NUMBER:
390307976
ADMINISTRATOR:MICHELE SMITHFACILITY TYPE:
850
ADDRESS:1790 SEQUOIA BOULEVARDTELEPHONE:
(209) 835-2783
CITY:TRACYSTATE: CAZIP CODE:
95376
CAPACITY: 108TOTAL ENROLLED CHILDREN: 108CENSUS: 67DATE:
05/10/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:28 AM
MET WITH:Michele Smith TIME COMPLETED:
12:45 PM
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On May 10, 2023, Licensing Program Analyst (LPA), Stacey Williams , met with Facility Representative, Michele Smith for an unannounced annual inspection. Program operates M-F from 7:00 am to 5:30 pm. Present during the visit were 8 staff caring for 67 children. Facility is in compliance with staff/children ratios required by regulation. The facility operates a preschool program with a toddler component. There is a shared space waiver on file. Criminal record clearances were verified.

Facility was toured indoors and outdoors and inspected for Health and Safety hazards. Classrooms have age-appropriate toys and equipment that are in good repair. Cubbies are located inside the classrooms. The facility has age-appropriate furniture and equipment including cots or mats. Parents take blankets home to wash every Friday. Children's toilets and sinks are appropriate in size and height for children. Restrooms are maintained clean, in good repair and with adequate supplies. Staff use a separate restroom. Solid waste vessels, including moveable bins, have tight-fitting covers and are in good repair. Cleaning products and Toxins are inaccessible to children. Medications are inaccessible to children. The isolation area for an ill child is in the Director’s office. Facility has more than one functioning carbon monoxide and smoke detector. The playground equipment is in good repair. No bodies of water were observed. Drinking water is readily available both indoors and outdoors by water bottles. There is one water fountain on the outside play structure that is currently inoperable. LPA discussed lead testing requirements for accessible water with the facility representative. Facility Representative stated the water sources were tested within the last two years. Per the Facility Representative, there were no exceedances.. Sign in/out is done electronically through the ProCare App. Infant sleep log is also done through this App.

Program provides morning/ afternoon snack and lunch. Twelve children and Nine staff files were reviewed. Files contained the required documentation by regulation. LPA discussed mandated reporter training with the Director. Mandated Reporter Training is current in staff files that were reviewed. Mandated Reporter Training is to be completed every two years and can be accessed at www.mandatedreporterca.com. CPR/First Aid certification was reviewed. Expiration date is 7/2023 for the Director.

LPA reviewed the Department's inspection authority and discussed with staff any changes that may occur regarding Director/Site Supervisor or an employee acting in the director's absence must be reported to department within 10 working days.

Report continues on subsequent page 809C---

SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Stacey Williams
LICENSING EVALUATOR SIGNATURE: DATE: 05/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/10/2023
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, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME: WEST VALLEY CHRISTIAN ACADEMY PRESCHOOL
FACILITY NUMBER: 390307976
VISIT DATE: 05/10/2023
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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 Centers Sections 101173 and 101226.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 publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

LPA discussed the safe sleep regulations with Facility Representative and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee [facility representative] of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

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.

No Title 22 deficiencies were observed in the areas that were evaluated.

LPA reviewed report with the Facility Representative, Michele Smith and provided copies of the report along with Appeal Rights. A notice of site visit was provided and posted by LPA Williams and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Stacey Williams
LICENSING EVALUATOR SIGNATURE:

DATE: 05/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2023
LIC809 (FAS) - (06/04)
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