SUSANVILLE STATE PRESCHOOL

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25On 6/5/24 at 8:15am, an annual inspection was made to the facility by Licensing Program Analyst (LPA), Sydney Sims. This program is operated by the Lassen County Office of Education on the McKinley Elementary School campus in rooms 22; 23; 24 and 25 and a Title 5 funded program. The facilities operating hours are 8:30am - 12:00pm, Monday–Friday, Facility is closed for the month of July. The facility was toured at 8:20am inside and outside and the floor and yard plan submitted by the licensee were verified. Facility operates in rooms 22-25. The facility representative and staff were supervising 12 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 bark and free of hazards. 6 children's records were reviewed at 9:01am. 4 staff records were reviewed at 9:13am. There were no deficiencies cited during today’s inspection SUPERVISORS NAME: Megan Aviles LICENSING EVALUATOR NAME: Sydney Sims LICENSING EVALUATOR SIGNATURE: DATE: 06/05/2024 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/05/2024 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 3 FACILITY NAME: SUSANVILLE STATE PRESCHOOLFACILITY NUMBER: 185406614 VISIT DATE: 06/05/2024 NARRATIVE 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32To 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. 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. 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). LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP. LPA referred facility representative to the Department website for leadhttps://www.cdss.ca.gov/inforesources/child-care-licensing/water-testing-information SUPERVISORS NAME: Megan Aviles LICENSING EVALUATOR NAME: Sydney Sims LICENSING EVALUATOR SIGNATURE: DATE: 06/05/2024 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/05/2024 FACILITY NAME: SUSANVILLE STATE PRESCHOOLFACILITY NUMBER: 185406614 VISIT DATE: 06/05/2024 NARRATIVE 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32LPA discussed the safe sleep regulations with facility representative and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed facility representative of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment. 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

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25On 6/5/24 at 8:15am, an annual inspection was made to the facility by Licensing Program Analyst (LPA), Sydney Sims. This program is operated by the Lassen County Office of Education on the McKinley Elementary School campus in rooms 22; 23; 24 and 25 and a Title 5 funded program. The facilities operating hours are 8:30am - 12:00pm, Monday–Friday, Facility is closed for the month of July. The facility was toured at 8:20am inside and outside and the floor and yard plan submitted by the licensee were verified. Facility operates in rooms 22-25. The facility representative and staff were supervising 12 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 bark and free of hazards. 6 children's records were reviewed at 9:01am. 4 staff records were reviewed at 9:13am. There were no deficiencies cited during today’s inspection SUPERVISORS NAME: Megan Aviles LICENSING EVALUATOR NAME: Sydney Sims LICENSING EVALUATOR SIGNATURE: DATE: 06/05/2024 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/05/2024 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 3 FACILITY NAME: SUSANVILLE STATE PRESCHOOLFACILITY NUMBER: 185406614 VISIT DATE: 06/05/2024 NARRATIVE 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32To 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. 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. 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). LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP. LPA referred facility representative to the Department website for leadhttps://www.cdss.ca.gov/inforesources/child-care-licensing/water-testing-information SUPERVISORS NAME: Megan Aviles LICENSING EVALUATOR NAME: Sydney Sims LICENSING EVALUATOR SIGNATURE: DATE: 06/05/2024 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/05/2024 FACILITY NAME: SUSANVILLE STATE PRESCHOOLFACILITY NUMBER: 185406614 VISIT DATE: 06/05/2024 NARRATIVE 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32LPA discussed the safe sleep regulations with facility representative and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed facility representative of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment. 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

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25On 6/5/24 at 8:15am, an annual inspection was made to the facility by Licensing Program Analyst (LPA), Sydney Sims. This program is operated by the Lassen County Office of Education on the McKinley Elementary School campus in rooms 22; 23; 24 and 25 and a Title 5 funded program. The facilities operating hours are 8:30am - 12:00pm, Monday–Friday, Facility is closed for the month of July. The facility was toured at 8:20am inside and outside and the floor and yard plan submitted by the licensee were verified. Facility operates in rooms 22-25. The facility representative and staff were supervising 12 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 bark and free of hazards. 6 children's records were reviewed at 9:01am. 4 staff records were reviewed at 9:13am. There were no deficiencies cited during today’s inspection SUPERVISORS NAME: Megan Aviles LICENSING EVALUATOR NAME: Sydney Sims LICENSING EVALUATOR SIGNATURE: DATE: 06/05/2024 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/05/2024 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 3 FACILITY NAME: SUSANVILLE STATE PRESCHOOLFACILITY NUMBER: 185406614 VISIT DATE: 06/05/2024 NARRATIVE 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32To 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. 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. 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). LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP. LPA referred facility representative to the Department website for leadhttps://www.cdss.ca.gov/inforesources/child-care-licensing/water-testing-information SUPERVISORS NAME: Megan Aviles LICENSING EVALUATOR NAME: Sydney Sims LICENSING EVALUATOR SIGNATURE: DATE: 06/05/2024 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/05/2024 FACILITY NAME: SUSANVILLE STATE PRESCHOOLFACILITY NUMBER: 185406614 VISIT DATE: 06/05/2024 NARRATIVE 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32LPA discussed the safe sleep regulations with facility representative and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed facility representative of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment. 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

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25On 6/5/24 at 8:15am, an annual inspection was made to the facility by Licensing Program Analyst (LPA), Sydney Sims. This program is operated by the Lassen County Office of Education on the McKinley Elementary School campus in rooms 22; 23; 24 and 25 and a Title 5 funded program. The facilities operating hours are 8:30am - 12:00pm, Monday–Friday, Facility is closed for the month of July. The facility was toured at 8:20am inside and outside and the floor and yard plan submitted by the licensee were verified. Facility operates in rooms 22-25. The facility representative and staff were supervising 12 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 bark and free of hazards. 6 children's records were reviewed at 9:01am. 4 staff records were reviewed at 9:13am. There were no deficiencies cited during today’s inspection SUPERVISORS NAME: Megan Aviles LICENSING EVALUATOR NAME: Sydney Sims LICENSING EVALUATOR SIGNATURE: DATE: 06/05/2024 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/05/2024 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 3 FACILITY NAME: SUSANVILLE STATE PRESCHOOLFACILITY NUMBER: 185406614 VISIT DATE: 06/05/2024 NARRATIVE 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32To 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. 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. 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). LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP. LPA referred facility representative to the Department website for leadhttps://www.cdss.ca.gov/inforesources/child-care-licensing/water-testing-information SUPERVISORS NAME: Megan Aviles LICENSING EVALUATOR NAME: Sydney Sims LICENSING EVALUATOR SIGNATURE: DATE: 06/05/2024 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/05/2024 FACILITY NAME: SUSANVILLE STATE PRESCHOOLFACILITY NUMBER: 185406614 VISIT DATE: 06/05/2024 NARRATIVE 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32LPA discussed the safe sleep regulations with facility representative and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed facility representative of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment. 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

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

Type B citation - potential risk if not corrected