PRAIRIE ELEMENTARY

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25Licensing Program Analyst (LPA) Christopher Bello arrived at the facility at approximately 8:30am met with Program Specialist, Shelli Pruger, regarding an Unusual Incident that took place January 29th, 2024. LPA made observations and interviewed staff regarding the incident. Program Specialist stated that she ordered the classroom to make a Nap Map of where the children will sleep with adequate distance apart from one another and to have enough light in the classroom for increased supervision. Title 22 Deficiencies have been cited on the attached LIC 809D. Upon receipt of Type A citations, facility shall post and provide copies of the LIC 809D for parents/guardians of children currently in care and for parents/guardians of newly enrolled children for the next 12 months. Facility must also keep the signed LIC 9224, Acknowledging Receipt of Licensing Reports LIC 809D in each child's files. This report was reviewed and discussed with licensee. A notice of site visit and appeal rights were provided. SUPERVISORS NAME: Amanda Blesi LICENSING EVALUATOR NAME: Christopher Bello LICENSING EVALUATOR SIGNATURE: DATE: 02/07/2024 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/07/2024 This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC809 (FAS) - (06/04)Page: 1 of 2 FACILITY NAME: PRAIRIE ELEMENTARY FACILITY NUMBER: 340318126 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 02/07/2024 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type A 02/08/2024 Section Cited CCR 101229(a)(1) 1 2 3 4 5 6 7No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation. This requirement has not been met by evidence: Incident that occurred on 1/29/24. This is considered as a1 2 3 4 5 6 7Facility self reported the incident. Program Specialist that they have an all staff training that they address the situation and will submit to LPA by POC date 2/8/24. 8 9 10 11 12 13 14immediate risk to the children in care.8 9 10 11 12 13 14 1 2 3 4 5 6 71 2 3 4 5 6 7 1 2 3 4 5 6 71 2 3 4 5 6 7 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:Amanda Blesi LICENSING EVALUATOR NAME:Christopher Bello LICENSING EVALUATOR SIGNATURE: DATE: 02/07/2024 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/07/2024

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25Licensing Program Analyst (LPA) Christopher Bello arrived at the facility at approximately 8:30am met with Program Specialist, Shelli Pruger, regarding an Unusual Incident that took place January 29th, 2024. LPA made observations and interviewed staff regarding the incident. Program Specialist stated that she ordered the classroom to make a Nap Map of where the children will sleep with adequate distance apart from one another and to have enough light in the classroom for increased supervision. Title 22 Deficiencies have been cited on the attached LIC 809D. Upon receipt of Type A citations, facility shall post and provide copies of the LIC 809D for parents/guardians of children currently in care and for parents/guardians of newly enrolled children for the next 12 months. Facility must also keep the signed LIC 9224, Acknowledging Receipt of Licensing Reports LIC 809D in each child's files. This report was reviewed and discussed with licensee. A notice of site visit and appeal rights were provided. SUPERVISORS NAME: Amanda Blesi LICENSING EVALUATOR NAME: Christopher Bello LICENSING EVALUATOR SIGNATURE: DATE: 02/07/2024 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/07/2024 This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC809 (FAS) - (06/04)Page: 1 of 2 FACILITY NAME: PRAIRIE ELEMENTARY FACILITY NUMBER: 340318126 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 02/07/2024 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type A 02/08/2024 Section Cited CCR 101229(a)(1) 1 2 3 4 5 6 7No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation. This requirement has not been met by evidence: Incident that occurred on 1/29/24. This is considered as a1 2 3 4 5 6 7Facility self reported the incident. Program Specialist that they have an all staff training that they address the situation and will submit to LPA by POC date 2/8/24. 8 9 10 11 12 13 14immediate risk to the children in care.8 9 10 11 12 13 14 1 2 3 4 5 6 71 2 3 4 5 6 7 1 2 3 4 5 6 71 2 3 4 5 6 7 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:Amanda Blesi LICENSING EVALUATOR NAME:Christopher Bello LICENSING EVALUATOR SIGNATURE: DATE: 02/07/2024 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/07/2024

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25Licensing Program Analyst (LPA) Christopher Bello arrived at the facility at approximately 8:30am met with Program Specialist, Shelli Pruger, regarding an Unusual Incident that took place January 29th, 2024. LPA made observations and interviewed staff regarding the incident. Program Specialist stated that she ordered the classroom to make a Nap Map of where the children will sleep with adequate distance apart from one another and to have enough light in the classroom for increased supervision. Title 22 Deficiencies have been cited on the attached LIC 809D. Upon receipt of Type A citations, facility shall post and provide copies of the LIC 809D for parents/guardians of children currently in care and for parents/guardians of newly enrolled children for the next 12 months. Facility must also keep the signed LIC 9224, Acknowledging Receipt of Licensing Reports LIC 809D in each child's files. This report was reviewed and discussed with licensee. A notice of site visit and appeal rights were provided. SUPERVISORS NAME: Amanda Blesi LICENSING EVALUATOR NAME: Christopher Bello LICENSING EVALUATOR SIGNATURE: DATE: 02/07/2024 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/07/2024 This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC809 (FAS) - (06/04)Page: 1 of 2 FACILITY NAME: PRAIRIE ELEMENTARY FACILITY NUMBER: 340318126 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 02/07/2024 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type A 02/08/2024 Section Cited CCR 101229(a)(1) 1 2 3 4 5 6 7No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation. This requirement has not been met by evidence: Incident that occurred on 1/29/24. This is considered as a1 2 3 4 5 6 7Facility self reported the incident. Program Specialist that they have an all staff training that they address the situation and will submit to LPA by POC date 2/8/24. 8 9 10 11 12 13 14immediate risk to the children in care.8 9 10 11 12 13 14 1 2 3 4 5 6 71 2 3 4 5 6 7 1 2 3 4 5 6 71 2 3 4 5 6 7 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:Amanda Blesi LICENSING EVALUATOR NAME:Christopher Bello LICENSING EVALUATOR SIGNATURE: DATE: 02/07/2024 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/07/2024

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25Licensing Program Analyst (LPA) Christopher Bello arrived at the facility at approximately 8:30am met with Program Specialist, Shelli Pruger, regarding an Unusual Incident that took place January 29th, 2024. LPA made observations and interviewed staff regarding the incident. Program Specialist stated that she ordered the classroom to make a Nap Map of where the children will sleep with adequate distance apart from one another and to have enough light in the classroom for increased supervision. Title 22 Deficiencies have been cited on the attached LIC 809D. Upon receipt of Type A citations, facility shall post and provide copies of the LIC 809D for parents/guardians of children currently in care and for parents/guardians of newly enrolled children for the next 12 months. Facility must also keep the signed LIC 9224, Acknowledging Receipt of Licensing Reports LIC 809D in each child's files. This report was reviewed and discussed with licensee. A notice of site visit and appeal rights were provided. SUPERVISORS NAME: Amanda Blesi LICENSING EVALUATOR NAME: Christopher Bello LICENSING EVALUATOR SIGNATURE: DATE: 02/07/2024 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/07/2024 This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC809 (FAS) - (06/04)Page: 1 of 2 FACILITY NAME: PRAIRIE ELEMENTARY FACILITY NUMBER: 340318126 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 02/07/2024 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type A 02/08/2024 Section Cited CCR 101229(a)(1) 1 2 3 4 5 6 7No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation. This requirement has not been met by evidence: Incident that occurred on 1/29/24. This is considered as a1 2 3 4 5 6 7Facility self reported the incident. Program Specialist that they have an all staff training that they address the situation and will submit to LPA by POC date 2/8/24. 8 9 10 11 12 13 14immediate risk to the children in care.8 9 10 11 12 13 14 1 2 3 4 5 6 71 2 3 4 5 6 7 1 2 3 4 5 6 71 2 3 4 5 6 7 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:Amanda Blesi LICENSING EVALUATOR NAME:Christopher Bello LICENSING EVALUATOR SIGNATURE: DATE: 02/07/2024 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/07/2024

Type A citation - immediate risk to health, safety, or personal rights

Type B citation - potential risk if not corrected