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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 100400331
Report Date: 01/10/2020
Date Signed: 01/10/2020 12:49:31 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:KIDS KARE WILLOWFACILITY NUMBER:
100400331
ADMINISTRATOR:ORTIZ, ERINFACILITY TYPE:
850
ADDRESS:3067 WILLOW AVENUETELEPHONE:
(559) 291-9111
CITY:CLOVISSTATE: CAZIP CODE:
93612
CAPACITY:81CENSUS: 35DATE:
01/10/2020
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Erin OrtizTIME COMPLETED:
01:15 PM
NARRATIVE
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On 01/10/2020, Licensing Program Analyst (LPA) Candis Rodriguez conducted an annual inspection. LPA met with Director Erin Ortiz and toured the facility, both indoors and outdoors. LPA took a census and observed thirty-five (35) total daycare children with eight (8) staff supervising in smaller groups. This is a combination center which provides care for children between ages 2-6 and school age children. Hours of operation are Monday through Friday, 6:15AM to 6:00PM.

There is a pool on site which is fenced according to regulations. Firearms and weapons are not allowed or stored on premises. All children are under supervision, including visual supervision, of a teacher at all times. There is a ratio of one teacher supervising no more than 12 children in attendance. Disinfectants, cleaning solutions and other dangerous items are inaccessible to children. No poisons were observed during today’s inspection. All materials and surfaces accessible to children are toxic free. All toilets, hand washing, and bathing facilities are in safe and sanitary operating conditions. All floors are clean and safe. Furniture and equipment are in good condition, free of sharp, loose, or pointed parts.

All kitchen, food prep, and storage areas are clean, free of litter, rubbish, and rodents/vermin. All food is protected from contamination, and contaminated food is discarded immediately. Solid waste storage vessels, including moveable bins, have tight-fitting covers, and are in good repair. Uncontaminated drinking water is available both indoors and outdoors. All foods/beverages capable of rapid spoiling are stored in covered containers at 45 (F) or less. Menus are posted at least one week in advance, where an authorized representative can view them.

Facility has one or more functioning carbon monoxide detectors that meet statutory requirements. Playground equipment is in good condition, free of sharp, loose, or pointed parts. Outdoor activity space surface is maintained in a safe condition and is free of hazards.
(Continued on LIC 809-C)
SUPERVISOR'S NAME: Alice JuarezTELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Candis RodriguezTELEPHONE: (559) 341-4117
LICENSING EVALUATOR SIGNATURE:

DATE: 01/10/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2020
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
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: KIDS KARE WILLOW
FACILITY NUMBER: 100400331
VISIT DATE: 01/10/2020
NARRATIVE
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Upon review of children’s files, LPA observed medical documentation in Child #1 and Child #2’s files which stated both children were diagnosed on 10/30/2019 with a communicable disease known as Hand-Foot-Mouth disease. Facility did not report these cases to Community Care Licensing as required. Director stated there were no other cases of this disease reported during that time, and both children returned after being cleared by their physician.

CCL shall notify a licensee to immediately terminate the employment of, or to remove/bar any person with specified convictions or for other reasons. The licensee shall comply with the notice. Before working or volunteering in a licensed child care facility, all individuals subject to a criminal record review have a clearance or exemption and have been associated to the facility. Staff records contain appropriate, documentation of education credits. At least one person trained in CPR and Pediatric first-aid is present when children are at the facility or at off-site activities. The person, who signs the child in/out, is responsible for the child, uses their full legal signature and records the time of day. Child's admission agreement is available for review.

Required CCL forms are posted on parent's board.

Incidental Medical Services (IMS) are not currently being provided. Licensee is aware that an IMS plan is required to be submitted to the licensing office if she provides these services. The following information regarding Americans with Disability Act (ADA) was provided: US Department of Justice toll free ADA Information line at (800) 514-0301(voice) and (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm for Commonly Asked Questions about Child Care Centers and the ADA.

LPA and Licensee discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINS), Quarterly Updates, Mandated Reporter Training, Lead Poisoning Facts, Forms and Regulations.

Per Chapter 1, Division 12, Title 22 of the California Code of Regulations, the following deficiencies are found: (see LIC809-D). Site Visit Notice posted on the parent board. Exit interview was conducted with Erin Ortiz. Licensee was provided a copy of appeal rights. THIS REPORT SHALL BE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS.

SUPERVISOR'S NAME: Alice JuarezTELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Candis RodriguezTELEPHONE: (559) 341-4117
LICENSING EVALUATOR SIGNATURE:

DATE: 01/10/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2020
LIC809 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: KIDS KARE WILLOW
FACILITY NUMBER: 100400331
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/10/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/07/2020
Section Cited

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101212(d) Upon the occurrence...a report shall be made to the Department by telephone or fax within the Department's next working day... In addition, a written report...shall be submitted to the Department within seven days following the occurrence...(1)Events reported shall include the following: (E) Epidemic outbreaks.
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This requirement was not met as evidenced by LPAs observations of children's files and interview with Director. Based on observation and interview, facility did not report a possible epidemic outbreak to CCL as required. This poses a potential risk to the health, safety, and personal rights of children in care.
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log to CCL by POC due date.

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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: Alice JuarezTELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Candis RodriguezTELEPHONE: (559) 341-4117
LICENSING EVALUATOR SIGNATURE:
DATE: 01/10/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/10/2020
LIC809 (FAS) - (06/04)
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