100406511-11-29-2022-57-CC-KMWS-CLMRU2-20221129121914

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 100406511
Report Date: 11/29/2022
Date Signed: 11/29/2022 12:19:34 PM

Document Has Been Signed on 11/29/2022 12:19 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
FRESNO SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME:	JUBILEE CITY PRESCHOOL & DAY CARE		FACILITY NUMBER:	100406511
ADMINISTRATOR:	ZANOVITCH, COLLEEN		FACILITY TYPE:	850
ADDRESS:	1800 PLUMAS		TELEPHONE:	(559) 897-5725
CITY:	KINGSBURG	STATE: CA	ZIP CODE:	93631
CAPACITY:	41	CENSUS: 9	DATE:	11/29/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Sarah Cortez		TIME COMPLETED:	12:30 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 November 29, 2022 Licensing Program Analyst (LPA) Kari McWilliams, conducted an unannounced Annual Required Inspection for the preschool license. LPA met with Director, Sarah Cortez, and toured the facility indoors and outdoors. Days and hours of operation are year round; Monday through Friday 7:00AM-6:00PM. There is no swimming pool or other bodies of water on the premises. There are no firearms or ammunition allowed or stored on the premises. Disinfectants, cleaning solutions, medication and other hazardous items are made inaccessible. No poisons were observed during the inspection. Furniture and equipment are in good condition, free of sharp, loose or pointed parts. The surface of the outdoor activity space needs maintenance and regular upkeep to ensure children’s safety; LPA McWilliams spoke to facility representative about different areas that are specifically in need of repair. LPA McWilliams advised facility representative that all windows need to have screens that are in good repair; some windows don't have screens while others are starting to fray. All toilets and handwashing facilities are in safe and sanitary operating condition. Floors in the facility are clean; LPA McWilliams advised facility representative that the transition spacers from carpet to tile need to be replaced; they are separating and starting to cause tripping hazards. All kitchen, food preparation and storage areas are clean, free of litter/rubbish and free of rodents/vermin. Parents provide all lunches for the children. All food is protected against contamination and any contaminated food is discarded immediately. Solid waste storage containers have tight-fitting covers and are in good repair. Drinking water is available both indoors and outdoors. The facility is free of flies, insects and rodents. Facility has one or more functioning carbon monoxide detectors that meet statutory requirements. continued on 809-c

SUPERVISOR'S NAME: Luisa Gavoutian	TELEPHONE: (559) 650-7879
LICENSING EVALUATOR NAME: Kari McWilliams	TELEPHONE: (559) 341-4724
LICENSING EVALUATOR SIGNATURE:	DATE: 11/29/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/29/2022

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 7

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: JUBILEE CITY PRESCHOOL & DAY CARE	FACILITY NUMBER: 100406511
	VISIT DATE: 11/29/2022

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
26
27
28
29
30
31
32

Facility Representative was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Capacity and limitations as specified on the license are being maintained. At least one person trained in CPR and Pediatric First Aid is present when children are at the facility or at offsite activities. 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 person who signs the child in/out of the facility shall use their full legal signature and record the time of day. All children are under supervision, including visual supervision, of a teacher at all times. Facility maintains a ratio of one teacher supervising no more than 12 children in care.

LPA reviewed a sample of children’s files and observed files were complete with contact information for authorized representative and or relatives or others who can assume responsibility for the child and medical assessment.

LPA reviewed a sample of staff files and observed files were complete with health screening, immunization records for influenza, pertussis and measles and current documentation of completed mandated reporter training.

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 they provide any of these services. Information regarding Americans with Disability Act (ADA) can be obtained by contacting US Department of Justice toll free ADA Information line at (800) 514-0301(voice), (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm.

LPA and Licensee 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, Safe Sleep in Child Care, Lead Poisoning Facts, Forms and Regulations.

continued on 809-c

SUPERVISOR'S NAME: Luisa Gavoutian	TELEPHONE: (559) 650-7879
LICENSING EVALUATOR NAME: Kari McWilliams	TELEPHONE: (559) 341-4724
LICENSING EVALUATOR SIGNATURE:	DATE: 11/29/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/29/2022

LIC809 (FAS) - (06/04)

Page: 3 of 7

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: JUBILEE CITY PRESCHOOL & DAY CARE	FACILITY NUMBER: 100406511
	VISIT DATE: 11/29/2022

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
26
27
28
29
30
31
32

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

Exit interview conducted and report was reviewed with the facility representative Sarah Cortez.

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, the following deficiencies are being cited: (see next page, 809 D) Licensee was provided a copy of their appeal rights.

This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.

SUPERVISOR'S NAME: Luisa Gavoutian	TELEPHONE: (559) 650-7879
LICENSING EVALUATOR NAME: Kari McWilliams	TELEPHONE: (559) 341-4724
LICENSING EVALUATOR SIGNATURE:	DATE: 11/29/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/29/2022

LIC809 (FAS) - (06/04)

Page: 4 of 7

Document Has Been Signed on 11/29/2022 12:19 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
FRESNO SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: JUBILEE CITY PRESCHOOL & DAY CARE	FACILITY NUMBER: 100406511
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 11/29/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101238(a)

Buildings and Grounds

(a) The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the licensee did not comply with the section cited above in LPA observed chipped paint on classroom walls, chipped/peeling paint on a table, carpet transition pieces are spreading apart causing a possible tripping hazard; which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 01/09/2023
	Plan of Correction
1 2 3 4	Facility represenative stated that she will communicate with the owners of the facility to ensure that these items are corrected. LPA will conduct a POC visit after the above POC date to ensure that these items are corrected.

Type B

Section Cited

CCR

101238.2(d)

Outdoor Activity Space

(d) The surface of the outdoor activity space shall be maintained: This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the licensee did not comply with the section cited above in LPA observed boards on building have damage, plastic house and kitchen are not in good repair, spider webs, painting of city scene along fence is peeling and falling off, the side of the building that is inaccesible to children is piled with wood, paint containers, other debri that could be fire hazard and needs to be cleaned out. These items which pose a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 01/09/2023
	Plan of Correction
1 2 3 4	Facility represenative stated that she will communicate with the owners of the facility to ensure that these items are corrected. LPA will conduct a POC visit after the above POC date to ensure that these items are corrected.

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: Luisa Gavoutian	TELEPHONE: (559) 650-7879
LICENSING EVALUATOR NAME: Kari McWilliams	TELEPHONE: (559) 341-4724
LICENSING EVALUATOR SIGNATURE:	DATE: 11/29/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/29/2022

LIC809 (FAS) - (06/04)

Page: 5 of 7