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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 485407942
Report Date: 03/15/2024
Date Signed: 03/15/2024 03:56:39 PM

Document Has Been Signed on 03/15/2024 03:56 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:ABOVE & BEYOND PRESCHOOLFACILITY NUMBER:
485407942
ADMINISTRATOR:ROWLAND, PAULAFACILITY TYPE:
850
ADDRESS:126 PEABODY ROADTELEPHONE:
(707) 386-3171
CITY:VACAVILLESTATE: CAZIP CODE:
95687
CAPACITY: 27TOTAL ENROLLED CHILDREN: 108CENSUS: 24DATE:
03/15/2024
TYPE OF VISIT:Annual/RequiredUNANNOUNCEDTIME BEGAN:
11:27 AM
MET WITH:Paula Rowland - LicenseeTIME COMPLETED:
04:15 PM
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A required annual inspection of the facility was conducted by Licensing Program Analyst (LPA), Melchisedeck Augustin, who met with Director, Paula Rowland. The facility file was reviewed prior to this inspection. A review of the personnel report on file indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. Licensee 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 is not registered with the Resource and Referral Agency’s (R/R), Food Program. The outdoor playground did not have 75 square feet per child and the facility has an approved waiver to allow the facility to rotate the children’s outdoor play time.

The facility’s operating hours are from 0:8 AM - 2:30 PM Monday-Friday and per the Director, there are two sessions held in between the operating hours. The facility was toured inside and out and the floor and yard plan submitted by the licensee were verified. Parents used their electronic signatures to sign their child(ren) in/out. Items which could pose a danger to children (such as detergents, cleaning compounds and medications) were observed to be out of reach, inaccessible to children. LPA did not observe any poison(s) on the premise. The toys, floors, desks and other equipment and surfaces are clean, toxic free, safe and in good condition. The children brought their own water bottles and snacks, and the facility had access to additional filtered water in a cooler. The facility had additional snacks stored if a child forgot to bring a snack. The children's bathrooms are in safe and sanitary condition. Garbage cans containing solid waste have tight fitting lids. LPA observed a working carbon monoxide detector, smoke alarm, and fire extinguisher rated at least 2A10BC in the facility. Last emergency drill was conducted on 02/08/24. (Continued on LIC809-C)
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Melchisedeck Augustin
LICENSING EVALUATOR SIGNATURE: DATE: 03/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/15/2024
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
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: ABOVE & BEYOND PRESCHOOL
FACILITY NUMBER: 485407942
VISIT DATE: 03/15/2024
NARRATIVE
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The playground equipment and surface areas are in safe condition. There is foam cushioning material underneath climbing structures and/or play equipment to absorb falls. There are no bodies of water observed on the site. Director stated no weapons are stored on site, and none were observed. During today's inspection, staffing ratios were being met, and 24 children were supervised by the Director and Assistant Directors, one teacher and one Aide. The facility was operating within the licensed capacity and ratio requirements. Five children’s (C1-C5) records were reviewed at 12:50pm which contained Consent for Emergency Medical Treatment, Identification and emergency Information (LIC 700), Physician’s Report (LIC 701), Child Health History (LIC 702). LPA noted C1 & C2 were missing evidence of Immunization. Four staff (CD, AD & S1-S2) records were reviewed at 12:07 PM which revealed CD was missing LIC 9096, S1’s record was missing AB 1207 Mandated Reporter Training certificate, Health Screening and proof of immunity against Measles, Pertussis and Influenza. Furthermore, S2 was missing proof of immunity against Measles, Pertussis and Influenza, and AD was missing LIC 9096 and proof of immunity against Influenza.


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 child care 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). The facility had not had its waters tested for lead and the Center Director felt that the facility was exempt from the requirements to test the water because they never used the water to wash fruits, prepare meals or consume. Center Director further stated the facility held two sessions during the operating hours, and children brought their own water bottles and snack(s), and the facility had access to additional water through a water dispensary; and the Director claimed a certified lead water technician told her that the facility was exempt from the requirements of testing its water. The 35 gallons water are delivered every two weeks. LPA discussed with the Director the facility’s requirements to test its waters for lead and the facility will need to request a waiver to be exempt from the requirements to test its water. (Continue to LIC 809-C)
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Melchisedeck Augustin
LICENSING EVALUATOR SIGNATURE:

DATE: 03/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2024
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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
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: ABOVE & BEYOND PRESCHOOL
FACILITY NUMBER: 485407942
VISIT DATE: 03/15/2024
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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 are available at: https://www.ada.gov/resources/child-care-centers/.

Licensee 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.

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.



Exit interview conducted and report was reviewed with the Licensee, Paula Rowland. Notice of Site Visit shall be posted for 30 days. Failure to comply with posting requirements shall result in an immediately civil penalty of $100. The following Title 22 Deficiencies were cited during today’s inspection. Appeal Rights were provided.
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Melchisedeck Augustin
LICENSING EVALUATOR SIGNATURE:

DATE: 03/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2024
LIC809 (FAS) - (06/04)
Page: 3 of 6
Document Has Been Signed on 03/15/2024 03:56 PM - It Cannot Be Edited


Created By: Melchisedeck Augustin On 03/15/2024 at 01:47 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: ABOVE & BEYOND PRESCHOOL
FACILITY NUMBER: 485407942

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/15/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on four staff (CD, AD & S1-S2) records reviewed at 12:07pm which revealed S1 was missing AB 1207 Mandated Reporter Training certificate. 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: 03/29/2024
Plan of Correction
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Center Director stated she would ensure S1 obtained a current AB 1207 Mandated Reporter Training certificate, and Director intends to submit a copy of S1's current certificate to the Department by 03/29/24 via mail or email. Email: melchisedeck.augustin@dss.ca.gov.
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 four staff (CD, AD & S1-S2) records reviewed at 12:07pm which revealed CD, AD & S1-S2 were missing required Immunization. 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: 03/29/2024
Plan of Correction
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Center Director stated she would ensure all staff obtained their required staff Immunization Records (IR), and the Director intends to submit evidence of staff's IR to the Department by 03/29/24 via mail or email. Email: melchisedeck.augustin@dss.ca.gov
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:Leslie Lepori
LICENSING EVALUATOR NAME:Melchisedeck Augustin
LICENSING EVALUATOR SIGNATURE:
DATE: 03/15/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/15/2024


LIC809 (FAS) - (06/04)
Page: 4 of 6
Document Has Been Signed on 03/15/2024 03:56 PM - It Cannot Be Edited


Created By: Melchisedeck Augustin On 03/15/2024 at 01:47 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: ABOVE & BEYOND PRESCHOOL
FACILITY NUMBER: 485407942

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/15/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
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 four staff (CD, AD & S1-S2) records reviewed at 12:07pm which revealed S1 was missing Health Screening. 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: 03/29/2024
Plan of Correction
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Center Director stated she would ensure S1 obtained a Health Screening and the Director intends to submit S1's completed LIC 503 to the Department by 03/29/24 via mail or emai: melchisedeck.augustin@dss.ca.gov
Type B
Section Cited
CCR
101217(a)(3)
Personnel Records
(a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information: (3) Date of employment.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on five children's (C1-C5) records reviewed at 12:50pm which revealed the records' cover page were missing DOB & DOA. 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: 03/29/2024
Plan of Correction
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Center Director stated she would reproduce each child's cover page to include details such as: sex, date of birth and date of admission. Center Director intends to submit evidence of completion of the new cover page to the Departmenty by 03/29/24 via mail or email.
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:Leslie Lepori
LICENSING EVALUATOR NAME:Melchisedeck Augustin
LICENSING EVALUATOR SIGNATURE:
DATE: 03/15/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/15/2024


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