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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 483010396
Report Date: 09/11/2023
Date Signed: 09/11/2023 02:12:24 PM

Document Has Been Signed on 09/11/2023 02:12 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:CLLAIMM ACADEMY 2FACILITY NUMBER:
483010396
ADMINISTRATOR:MARENA SIMMONSFACILITY TYPE:
840
ADDRESS:1241 ANDERSON DRIVETELEPHONE:
(707) 712-6007
CITY:SUISUN CITYSTATE: CAZIP CODE:
94585
CAPACITY: 30TOTAL ENROLLED CHILDREN: 0CENSUS: DATE:
09/11/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Marena SimmonsTIME COMPLETED:
02:45 PM
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Licensing Program Analyst (LPA) Glenn Ouye met with Marena Simmons to conduct the prelicensing inspection of CLLAIMM ACADEMY 2 located at 1241 Anderson Dr. Suisun City. The application was received on March 16, 2023 requesting a capacity of 11 school age children. The building needed partial finish construction work to be completed and the outdoor activity area also needed to be installed. The program will also have a preschool program which has it's own classroom, bathrooms and outdoor activity area. The fire clearance was approved on September 7, 2023.

The school age center program will utilize room 4. There is sufficient furniture, equipment and toys for the children.
Sufficient first aid supplies are required at the center at all times. The facility will utilize an electronic sign in and sign out program to record daily attendance.
There is a fire extinguishers and fire alarm pull station near the exit door. There is a functional smoke and carbon monoxide detector. All outlets have safety electrical outlets

There is bathroom with a toilet and urinal and two sinks. There is a separate staff bathroom in the administration office which can be used by a sick child while waiting for their parent to pick them up. There is sufficient square footage for the requested capacity of 11 school age children. The outdoor area has sufficient square footage for 10 school age children. The facility will utilize an outdoor rotational waiver that will not exceed 10 children.

Licensee 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: 09/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/11/2023
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: CLLAIMM ACADEMY 2
FACILITY NUMBER: 483010396
VISIT DATE: 09/11/2023
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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 licensee the LIC 311A, Records to Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted.

Licensee 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 be given to licensee for any facility inspection other than a prelicensing inspection and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

The licensee is completing the installation of a fence and landscaping in the outdoor activity area. Upon completion of the outdoor area the facility will be approved for licensure. The licensee agrees to send photos of the completed outdoor landscaping to become licensed.

Exit interview conducted and report was reviewed with the licensee, Marena Simmons.
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Glenn Ouye
LICENSING EVALUATOR SIGNATURE:

DATE: 09/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2023
LIC809 (FAS) - (06/04)
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