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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 480101919
Report Date: 08/22/2024
Date Signed: 08/22/2024 04:35:51 PM

Document Has Been Signed on 08/22/2024 04:35 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
SANTA ROSA CC RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:NORTH HILLS CHRISTIAN SCHOOLFACILITY NUMBER:
480101919
ADMINISTRATOR/
DIRECTOR:		LUDEZA PARINASFACILITY TYPE:
850
ADDRESS:200 ADMIRAL CALLAGHAN LANETELEPHONE:
(707) 644-5284
CITY:VALLEJOSTATE: CAZIP CODE:
94591
CAPACITY: 132TOTAL ENROLLED CHILDREN: 132CENSUS: DATE:
08/22/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:53 AM
MET WITH:Ludeza ParinasTIME VISIT/
INSPECTION COMPLETED:
04:35 PM
NARRATIVE
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A required annual/randome inspection was made to the facility by Licensing Program Analyst (LPA), Cindy Castro. LPA met with facility representative, Ludeza Parinas, Center Director (CD). Facility representative was reminded that all adults 18 and over, 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.

The facility’s operating hours are 6:00AM- 6:00PM, Monday – Friday, year-round. The facility was toured inside and outside, and the floor and yard plan submitted by the licensee was verified. Sign in/out records were reviewed. Items which could pose a danger to children (such as detergents, cleaning compounds and medications) were observed to be inaccessible to children and located out of reach of children.

CD stated there are no poisons in the facility, and none were observed during this inspection. The toys, floors, and other equipment and surfaces appeared clean, toxic free, safe for children and in good condition. Facility has age-appropriate furniture and equipment. The bathrooms and hand washing areas appeared to be in safe and sanitary operating condition. There was sufficient napping equipment available that met the requirements.

Continued on LIC 809-C.

SUPERVISORS NAME: Alexis Hollon
LICENSING EVALUATOR NAME: Cindy Castro
LICENSING EVALUATOR SIGNATURE: DATE: 08/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/22/2024
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
SANTA ROSA CC RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: NORTH HILLS CHRISTIAN SCHOOL
FACILITY NUMBER: 480101919
VISIT DATE: 08/22/2024
NARRATIVE
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The center’s isolation area for any child who becomes ill while in care is in Center Director office. There is drinking water available to children both indoors and outdoors. There are drinking fountains inside each classroom and on the playground. Food prep areas are clean. AM/PM snack is provided by the center, children bring their own lunch or lunch is purchased by an outside source. Food is properly stored and refrigerated as needed. There was no contaminated food observed. A current menu was posted on parent board in each classroom. The Daily Activities schedule, the Emergency Disaster Plan (LIC 610), and Parents’ Rights (PUB 393) were posted. Garbage cans containing solid waste have tight fitting lids. Each classroom had a working carbon monoxide and smoke detectors, and a fully charged fire extinguisher rated at least 2A10BC. The playground was free of hazards. LPA observed the playground equipment and surface areas were in safe condition. The playground has a blacktop material to absorb the children's falls. There are no bodies of water observed on the site. CD stated no weapons are stored on site, and none were observed.

During today's inspection, staffing ratios were being met, a total of 52 children were being supervised by 6 teachers and one teacher assistant. The facility was operating within the licensed capacity and ratio requirements. At least one staff member present during the visit possessed current CPR and First Aid certification, which expires 06/2026.

Twelve children’s records were reviewed. Eight staff files were reviewed.

LPA verified that the lead testing was completed in accordance with the Written Directives outlined in PIN 21-21.1-CCP. Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For childcare center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP). CCC completed testing and is compliant. Continued on LIC809-C

SUPERVISORS NAME: Alexis Hollon
LICENSING EVALUATOR NAME: Cindy Castro
LICENSING EVALUATOR SIGNATURE:

DATE: 08/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2024
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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
SANTA ROSA CC RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: NORTH HILLS CHRISTIAN SCHOOL
FACILITY NUMBER: 480101919
VISIT DATE: 08/22/2024
NARRATIVE
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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 PIN 22-02-CCP. 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 are available at: https://www.ada.gov/resources/child-care-centers/.

Facility representative was informed of the MyChildCarePlan.org website; 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.

The following violations of the California Code of Regulations, Title 22; Division 12, were observed: see LIC 809D. Appeal Rights were provided.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

A notice of site visit was given to facility representative and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

Exit interview conducted and report was reviewed with the facility representative, Ludeza Parinas.

SUPERVISORS NAME: Alexis Hollon
LICENSING EVALUATOR NAME: Cindy Castro
LICENSING EVALUATOR SIGNATURE:

DATE: 08/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2024
LIC809 (FAS) - (06/04)
Page: 3 of 5
Document Has Been Signed on 08/22/2024 04:35 PM - It Cannot Be Edited


Created By: Cindy Castro On 08/22/2024 at 03:35 PM
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
, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

FACILITY NAME: NORTH HILLS CHRISTIAN SCHOOL
FACILITY NUMBER: 480101919

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/22/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.7995(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on Staff Records review at 12:39pm, which revealed the licensee did not comply with the section cited above for Staff S5, which was missing proof of immunization against influenza, pertusssis, and measles, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/23/2024
Plan of Correction
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Center Director stated she would submit proof of immunizations, to the Department for staff S5 by 09/23/24. Email: cindy.castro@dss.ca.gov & Fax: 707-588-5099
Type B
Section Cited
CCR
101216(g)(1)
Personnel Requirements
(1) Except as specified in (3) below, good physical health shall be verified by a health screening, including a test for tuberculosis, performed by or under the supervision of a physician not more than one year prior to or seven days after employment or licensure.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on Staff Record review at 12:39pm, which revealed the licensee did not comply with the section cited above for Staff S5, who was missing form LIC503, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/23/2024
Plan of Correction
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Center Director stated she would submit proof to the Department of Health Screening, Form LIC503 for staff S5 by 09/23/24. Email: cindy.castro@dss.ca.gov & Fax: 707-588-5099
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:Alexis Hollon
LICENSING EVALUATOR NAME:Cindy Castro
LICENSING EVALUATOR SIGNATURE:
DATE: 08/22/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/22/2024


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 08/22/2024 04:35 PM - It Cannot Be Edited


Created By: Cindy Castro On 08/22/2024 at 03:35 PM
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
, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

FACILITY NAME: NORTH HILLS CHRISTIAN SCHOOL
FACILITY NUMBER: 480101919

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/22/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101220(a)
Child's Medical Assessments
(a) Prior to, or within 30 calendar days following the enrollment of a child, the licensee shall obtain a written medical assessment of the child. This medical assessment enables the licensee to assess whether the center can provide necessary health-related services to the child.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on Childrens Record review at 2:22pm,which revealed Child C1 was missing Physcian's Report LIC701, the licensee did not comply with the section cited above,which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/23/2024
Plan of Correction
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Center Director stated she would submit proof to the Department of Medical Assesment, Form LIC701 for Child C1 by 09/23/24. Email: cindy.castro@dss.ca.gov & Fax: 707-588-5099
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Alexis Hollon
LICENSING EVALUATOR NAME:Cindy Castro
LICENSING EVALUATOR SIGNATURE:
DATE: 08/22/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/22/2024


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