Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 483008714
Report Date: 11/04/2015
Date Signed 11/04/2015 02:25:27 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928
FACILITY NAME:LITTLE ANGELS PRESCHOOLFACILITY NUMBER:
483008714
ADMINISTRATOR:LINDA MARGARET REIDFACILITY TYPE:
850
ADDRESS:1350 AMADOR STREETTELEPHONE:
(707) 342-8815
CITY:VALLEJOSTATE: CAZIP CODE:
94590
CAPACITY:12CENSUS: 7DATE:
11/04/2015
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Linda ReidTIME COMPLETED:
02:45 PM
NARRATIVE
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An unannounced visit was made to the facility by LPA, Kevin O'Connell. This facility was toured inside and outside and the facility appeared clean and orderly. The items which could pose a danger to children (detergents, cleaning compounds, and medications) were stored out of the reach of children. Director states that there are no poisons but understands that they are to be locked (key or combination) in an "off limits" area. The toys, floors, desks and other equipment appeared clean. There is drinking water available to children both indoors and outdoors. There was one functioning carbon monoxide/ fire detector today. There was at least one charged fire extinguisher. Children bring their lunch. The children's bathrooms appeared in safe and sanitary operating condition. The playground equipment appeared in safe condition. There was cushioning material underneath climbing structures and/or play equipment to absorb falls. During today's visit staffing ratios were being met. There was at least one staff members present who possessed current CPR and First Aid certifications at today's visit. Two staff files were reviewed today. All licensing reports are public information and must be made available upon request. There were no bodies of water present and no dangerous weapons on the premises. There was one teacher who had not been associated but had criminal clearance. Licensee is not administering any Incidental Medical Services at this time. Issue was discussed and information was given.
Notice of Site Visit shall be posted for 30 days from today's visit.
See LIC 809 D for citations, appeal rights given.
SUPERVISOR'S NAME: Linda WalkerTELEPHONE: (707) 588-5026
LICENSING EVALUATOR NAME: Kevin O'ConnellTELEPHONE: (707) 588-5026
LICENSING EVALUATOR SIGNATURE:

DATE: 11/04/2015
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2015
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, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928
FACILITY NAME: LITTLE ANGELS PRESCHOOL
FACILITY NUMBER: 483008714
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/04/2015
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/05/2015
Section Cited
101170(e)(2)
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101170(e)(2) Criminal Record Clearance. Prior to working or volunteering in a licensed child care facility, all individuals subject to a criminal record review shall request a transfer of a criminal record clearance from another facility or Trustline.
Teacher Sandra Hulse's criminal clearance was not transferred to this facility and has worked here since Monday. A civil penalty applies.
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Director will fax the transfer form and driver's license to CCL by 11/5/15 and confirm association before teacher works at the facility again.

Fax (707) 588-5099
kevin.oconnell@dss.ca.gov
Front desk (707) 588-5026
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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: Linda WalkerTELEPHONE: (707) 588-5026
LICENSING EVALUATOR NAME: Kevin O'ConnellTELEPHONE: (707) 588-5026
LICENSING EVALUATOR SIGNATURE:

DATE: 11/04/2015
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2015
LIC809 (FAS) - (06/04)
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