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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 100404093
Report Date: 05/06/2019
Date Signed: 05/09/2019 10:50:55 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:FUSD-SCANDINAVIAN CHILD DEVELOPMENT CENTERFACILITY NUMBER:
100404093
ADMINISTRATOR:MADDEN, KATHERINEFACILITY TYPE:
850
ADDRESS:3360 NORTH SIERRA VISTATELEPHONE:
(559) 457-3683
CITY:FRESNOSTATE: CAZIP CODE:
93726
CAPACITY:53CENSUS: 29DATE:
05/06/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Lead teacher Jennifer Goosey and Site Supervisor Jacque BurrellTIME COMPLETED:
10:40 AM
NARRATIVE
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An unannounced Annual/Random inspection was conducted by Licensing Program Analyst Patricia Musso today. A tour of this facility was conducted inside and outside. Staff and children were spoken to during inspection.
The following areas are in compliance:
There are no bodies of water, fire arms, weapons, ammunition, or poisons stored on the premises. Disinfectants, cleaning compounds, and other hazardous items are inaccessible to children. Furniture and equipment are sufficient, age appropriate and in good repair.
The playground equipment and outdoor activity space is maintained and in good condition. Areas around/under climbing and play structures has sufficient cushion to absorb falls. Jennifer was reminded to have the bark raked out from under the play structure and to the landing areas of the play structure. Children's toilets, hand washing facilities are safe and sanitary. Rooms are safe and clean.
Food preparation area is clean, and food is protected from contamination Menus are posted. Trash cans with solid waste have tight fitting lids. Sanitary drinking water is available inside and out with drinking faucets. The facility is in compliance with conditions and limitations specified on the license. Teacher/child ratios are maintained and adequate supervision is being provided during this visit. No excluded individuals are present. Staff subject to a criminal record clearance or exemption are associated to the facility.
First aid/CPR reviewed and in compliance. Health screening reviewed for some teachers.
Sign in/sign out sheets maintained in compliance. Emergency information/medical assessment reviewed for some children. Facility is aware of Incidental Medical Services and IMS plans but at this time they are not administering medication to any child.

This facility operates a full day, year round program, Monday - Friday,
7:00 AM -5:30 PM.
SUPERVISOR'S NAME: Duane MatsubaraTELEPHONE: (559)650-7855
LICENSING EVALUATOR NAME: Patricia MussoTELEPHONE: (559) 341-5422
LICENSING EVALUATOR SIGNATURE:

DATE: 05/06/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/06/2019
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: FUSD-SCANDINAVIAN CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 100404093
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/06/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/20/2019
Section Cited
CCR
1596.7995(c)
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Health & Safety Code -1596.7995(c) - Employees failed to have appropriate complete records for immunizations (Influenza, Pertussis & Measles) by 9/1/16.
This requirement was not met as evidenced by no proof of the SB792 required for immunization/vaccines while reviewing staff
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Jacque said she believes that all staff have the required immunization/vaccines but could not find today in staff files. Jacque will contact headquarters to see if immunization records are there. If teachers do not have immunization records to
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files. This poses a potential risk to the health, safety, or personal rights of children in care.
evidenced by no proof of the SB792 required for immunization/vaccines while reviewing staff files. This poses a potential risk to the health, safety, or personal rights of children in care.
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fulfill the requirement, staff will need to get the required Pertussis, measles and flu per SB792. Jennifer or Jacque will contact/call LPA with the information of the staff having or not having the immunizations/vaccines by 5/20/19
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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: Duane MatsubaraTELEPHONE: (559)650-7855
LICENSING EVALUATOR NAME: Patricia MussoTELEPHONE: (559) 341-5422
LICENSING EVALUATOR SIGNATURE:

DATE: 05/06/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/06/2019
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: FUSD-SCANDINAVIAN CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 100404093
VISIT DATE: 05/06/2019
NARRATIVE
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LPA & Jacque discussed the Community Care Licensing website www.ccld.ca.gov
After viewing the teachers certificates, LPA reminded Jacque that the Mandated Reporter Training is required to be completed every two years.
LPA also discussed new additions to the website that include the new PIN (Provider Inform- ation Notification) and information for providers including the Quarterly Update that informs licensees of new legislation and regulations. Please follow these steps go to http://www.cdss.ca.gov/, click on “information and resources” click “Community Care Licensing” Click “quarterly updates” click “Child Care advocates program” and register to PIN.

During the exit interview that was conducted, LPA viewed the Notice of Site Visit Form that was left today being posted and left instructions that it is to be posted for 30 days

Jennifer and Jacque were also advised this report must remain posted for 30 days where parents may easily view and filed in facility file for public review for 3 years.

Jacque confirmed that there are no Registered Sex Offenders living in the facility and/or using the facility address for their mailing address.

Per Chapter 3, Division 12, Title 22 of the California Code of Regulations, the following deficiency is cited on LIC809D (see next page):

Site representative is to send updated LIC500 and LIC610 when changes occur.


SUPERVISOR'S NAME: Duane MatsubaraTELEPHONE: (559)650-7855
LICENSING EVALUATOR NAME: Patricia MussoTELEPHONE: (559) 341-5422
LICENSING EVALUATOR SIGNATURE:

DATE: 05/06/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/06/2019
LIC809 (FAS) - (06/04)
Page: 3 of 3