485408010-8-15-2023-13-CC-LCHZ-CUQTC5-20230815143611

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 485408010
Report Date: 08/15/2023
Date Signed: 08/15/2023 02:36:18 PM

Document Has Been Signed on 08/15/2023 02:36 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, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME:	WORLD CHANGERS ACADEMY (SA)		FACILITY NUMBER:	485408010
ADMINISTRATOR:	MEJIA, ERICA		FACILITY TYPE:	840
ADDRESS:	470 EAST H STREET		TELEPHONE:	(707) 365-5639
CITY:	DIXON	STATE: CA	ZIP CODE:	95620
CAPACITY: 60	TOTAL ENROLLED CHILDREN: 35	CENSUS: 7	DATE:	08/15/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:50 PM
MET WITH:	Erica Mejia		TIME COMPLETED:	02:45 PM

NARRATIVE

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On 8/15/2023 at 12:50pm, a Required - 1 Year inspection was made to the facility by Licensing Program Analyst (LPA), Laura Chavez. The school-age program operates 6:30am-6:00pm, Monday–Friday.The facility was toured at 1:40pm inside and outside and the floor and yard plan submitted by the licensee were verified. The school-age program operates in the sanctuary.

Two teachers and one aide were supervising seven children, and operating within the licensed capacity and ratio requirements. There are no pools or bodies of water on the premises. The outdoor activity space was cushioned with grass and free of hazards. Five children's records were reviewed at 1:20pm. Three staff records were reviewed at 1:00pm.

The following deficiency was cited [HSC 1597.16(a)(1)-Lead Water Testing was not completed prior to January 1, 2023 (see LIC 809D):

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.

SUPERVISORS NAME: Megan Aviles
LICENSING EVALUATOR NAME: Laura Chavez
LICENSING EVALUATOR SIGNATURE:	DATE: 08/15/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2023

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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Document Has Been Signed on 08/15/2023 02:36 PM - It Cannot Be Edited

Created By: Laura Chavez On 08/15/2023 at 02:13 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
, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME: WORLD CHANGERS ACADEMY (SA)	FACILITY NUMBER: 485408010
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/15/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1597.16(a)(1)

Lead Testing

(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on a record review, the licensee did not comply with the section cited above in one out of one reveiw of test results which posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 08/15/2023
	Plan of Correction
1 2 3 4	Facility Director provided a copy of the Result Summary indicating lead testing in water at the facility was completed on 4/6/2023. Results indicate the level of lead was below the level of 5.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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:

Megan Aviles

LICENSING EVALUATOR NAME:

Laura Chavez

LICENSING EVALUATOR SIGNATURE:

DATE: 08/15/2023

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2023

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, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME: WORLD CHANGERS ACADEMY (SA)	FACILITY NUMBER: 485408010
	VISIT DATE: 08/15/2023

NARRATIVE

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Director Erica Mejia 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.

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.

LPA referred Facility Director Erica Mejia to the Department website for lead:https://www.cdss.ca.gov/inforesources/child-care-licensing/water-testing-information

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. When any IMS is provided, a Plan for Providing 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)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.

Facility Director 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.

A notice of site visit was given and must remain posted for 30 days. An exit interview was conducted and report was reviewed with Director Erica Mejia.

SUPERVISORS NAME: Megan Aviles
LICENSING EVALUATOR NAME: Laura Chavez
LICENSING EVALUATOR SIGNATURE:	DATE: 08/15/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2023

LIC809 (FAS) - (06/04)

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