100406337-4-28-2022-04-CC-ASLR-CDWS4V-20220428133322

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 100406337
Report Date: 04/28/2022
Date Signed: 04/28/2022 01:33:29 PM

Document Has Been Signed on 04/28/2022 01:33 PM - It Cannot Be Edited

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-LOWELL		FACILITY NUMBER:	100406337
ADMINISTRATOR:	MADDEN, KATHERINE (KAY)		FACILITY TYPE:	850
ADDRESS:	171 N. POPLAR		TELEPHONE:	(559) 457-3690
CITY:	FRESNO	STATE: CA	ZIP CODE:	93701
CAPACITY:	21	CENSUS: 10	DATE:	04/28/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Isabel Aguilera / Charlotte Miranda		TIME COMPLETED:	01:45 PM

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	On 04/28/22, Licensing Program Analysts (LPAs) Angelica Slaughter and Ka Vang conducted an unannounced annual inspection at the facility. LPAs met with Substitute Teacher Isabel Aguilera and Health and Safety Supervisor Charlotte Miranda and toured the facility indoors and outdoors. The single classroom facility is located on the grounds of Lowell Elementary School. There were no bodies of water, firearms and/or ammunition on the premises. No poisons were observed during the inspection. Furniture and equipment were in good condition, free of sharp, loose or pointed parts. Playground equipment was in safe condition, free of sharp, loose or pointed parts. The surface of the outdoor activity space was maintained in a safe condition and was free of hazards. Areas around high climbing equipment and slides have wood chip cushioning material to absorb falls. Children's toilets and hand washing facilities were sanitary and in good operating condition. Floors in the facility were clean and safe. The facility was free of flies, insects, and rodents/vermin. Solid waste storage containers had tight-fitting covers and were in good repair. Meals are not served on site, children take home a cafeteria prepared meal to consume at home if desired. Drinking water was available both indoors and outdoors. The facility had one or more functioning carbon monoxide detectors that meet statutory requirements. Capacity and limitations as specified on the license are being maintained. The name of the child care center Director or fully qualified teacher(s) designated to act in the Director's absence has been reported to the Department. The facility maintains a ratio of one teacher supervising no more than 12 children in care. All children are to be under supervision, including visual supervision, of a teacher at all times. The person who signs the child in/out of the facility shall use their full legal signature and record the time of day. A sample of children's files were reviewed and contained contact information for authorized representative and/or relatives or others who can assume responsibility for the child and medical assessment. LPA also reviewed a sample of staff files and observed they contained health screening, immunization records for influenza, pertussis, and measles and current documentation of completed Mandated Reporter Training. At least one person trained in CPR and pediatric First Aid is present when children are at the facility or at off-site activities.

SUPERVISOR'S NAME: Diana deLeon	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Angelica Slaughter	TELEPHONE: (559) 341-3920
LICENSING EVALUATOR SIGNATURE:	DATE: 04/28/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2022

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: FUSD-LOWELL	FACILITY NUMBER: 100406337
	VISIT DATE: 04/28/2022

NARRATIVE

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The facility is with Fresno Unified School District and staff have a fingerprint clearance as a condition of employment.

This is an AM/PM half day preschool program which operates in preschool room 1 on a traditional school year schedule. The morning session is from 8:15 am to 11:15 am and the afternoon session is from 11:45 am to 2:45 pm, Monday through Friday.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation interpretations and Procedures for Child Care Centers Section 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes 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 ADA, available at: http://www.ada.gov/childqanda.htm

LPA and Health and Safety Supervisor discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINs), Quarterly Updates, COVID-19 Information and Resources, Mandated Reporter Training, Lead Poisoning Facts, Forms and Regulations.

Per Title 22, Division 12, Chapter 1 of the California Code of Regulations, the following deficiency was found (see next page, 809 D):

A copy of the appeal rights was also provided on this inspection.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with Charlotte Miranda.

SUPERVISOR'S NAME: Diana deLeon	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Angelica Slaughter	TELEPHONE: (559) 341-3920
LICENSING EVALUATOR SIGNATURE:	DATE: 04/28/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 04/28/2022 01:33 PM - It Cannot Be Edited

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-LOWELL	FACILITY NUMBER: 100406337
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/28/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101229(a)(1)

Responsibility for Providing Care and Supervision

(a) The licensee shall provide care and supervision as necessary to meet the children's needs. (1) No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the facility staff did not comply with the section cited above in that during this inspection, on two occassions children were observed in the restroom washing their hands without supervision, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 05/12/2022
	Plan of Correction
1 2 3 4	Staff will be trained on supervision of children and how to prevent this type of incident from occurring in the future. Staff will sign in for training and proof of training will be submitted to CCLD by the POC due date of 05/12/22.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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: Angelica Slaughter	TELEPHONE: (559) 341-3920
LICENSING EVALUATOR SIGNATURE:	DATE: 04/28/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2022

LIC809 (FAS) - (06/04)

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