100404078-2-27-2020-04-CC-JPAO-BM7QQF-20200227112217

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 100404078
Report Date: 02/27/2020
Date Signed: 02/27/2020 11:22:29 AM

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:	PANDA'S FOWLER PRESCHOOL		FACILITY NUMBER:	100404078
ADMINISTRATOR:	DIXON-BREWER, LORIE		FACILITY TYPE:	850
ADDRESS:	231 SOUTH SIXTH STREET		TELEPHONE:	(559) 834-1395
CITY:	FOWLER	STATE: CA	ZIP CODE:	93625
CAPACITY:	61	CENSUS: 52	DATE:	02/27/2020
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Maria Aguilera - Site Supervisor		TIME COMPLETED:	11:30 AM

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	(2) On 2/27/2020 Licensing Program Analyst (LPA), Joseph Pacheco, conducted an unannounced Required One Year inspection. LPA met with Site Supervisor, Maria Aguilera and a tour of the facility was conducted inside and outside. The following areas were in compliance during today’s inspection: There are no bodies of water present at this facility. There are no firearms or ammunition allowed on the premises. Disinfectants, hazardous items and medications are inaccessible to children. Storage area for poisons is locked. Furniture and equipment are sufficient, age appropriate and in good repair. The playground equipment and outdoor activity space is maintained and in good condition with adequate cushioning material. Children's toilets, hand washing facilities are sanitary. Rooms are safe and clean. Food preparation area is clean, food and beverages are stored in covered containers at 45 degrees F or less if required, and storage containers for solid waste are covered. Drinking water is available both indoors and outside. Measures are taken to keep facility free of insects and rodents. Staff subject to a criminal record clearance or exemption are associated to the facility. No excluded individuals are present. Teacher-child ratios are maintained and adequate supervision was observed during today’s inspection. First Aid/CPR credentials were reviewed and expire on 1/7/2022. AB 1207 certification for staff is current. Children’s records were reviewed to ensure proper forms are located within each child’s file. Staff records contain documentation of education, training, and/or experience. Menus are posted. Sign in/sign out sheets were not maintained. This facility operates a full day program from 7:30am to 4:30pm and a half day program from 8:00am to 12:00pm. Incidental Medical Services (IMS) policy was discussed. Incidental Medical Services (IMS) are not currently being provided. 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:

SUPERVISOR'S NAME: Diana deLeon	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Joseph Pacheco	TELEPHONE: (559) 341-4457
LICENSING EVALUATOR SIGNATURE:	DATE: 02/27/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2020

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, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: PANDA'S FOWLER PRESCHOOL	FACILITY NUMBER: 100404078
	VISIT DATE: 02/27/2020

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Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

An exit interview was conducted with Site Supervisor. LPA provided Site Supervisor with information regarding providing incidental medical services to children, the CDSS Provider Information Notices (PINs) communication system, and some important resources and information links offered on the CDSS website. Lead safety information was provided in accordance with AB 2370, Chapter 676, Statues of 2018.

Per Chapter 1, Division 12, Title 22 of the California Code of Regulations, the following deficiencies are found (see LIC809-D):

Copy of appeal Rights left with Site Supervisor.

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: Diana deLeon	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Joseph Pacheco	TELEPHONE: (559) 341-4457
LICENSING EVALUATOR SIGNATURE:	DATE: 02/27/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2020

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, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: PANDA'S FOWLER PRESCHOOL	FACILITY NUMBER: 100404078
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/27/2020

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 03/06/2020 Section Cited	1 2 3 4 5 6 7	Sign in and sign out. (1) The person who signs the child in/out shall use his/her full legal signature and shall record the time of day. (b) The person who brings the child to, and removes the child from, the center shall sign the child in/out.
	8 9 10 11 12 13 14	This requirement was not met as evidenced by LPA observation of sign in and sign out records. LPA observed four authorized representatives of children who did not sign in and sign out a child on the correct date. This is a potential risk to the health, safety, or personal rights of children in care.	8 9 10 11 12 13 14	In addition, Director to disseminate information/advisory notice to parent's informing them of the requirement to sign their children in/out daily. Copy of plan devised, including staff training and advisory notice provided to parents to be submitted to LPA by 3/6/2020.
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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: Diana deLeon	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Joseph Pacheco	TELEPHONE: (559) 341-4457
LICENSING EVALUATOR SIGNATURE:	DATE: 02/27/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2020

LIC809 (FAS) - (06/04)

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