100406724-1-16-2020-04-CC-CROZ-BKVPZF-20200116104529

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 100406724
Report Date: 01/16/2020
Date Signed: 01/16/2020 10:45:41 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:	FRESNO EOC CLOVIS HEAD START		FACILITY NUMBER:	100406724
ADMINISTRATOR:	AVELLAR, THERESA		FACILITY TYPE:	850
ADDRESS:	510 BARSTOW		TELEPHONE:	(559) 263-1200
CITY:	CLOVIS	STATE: CA	ZIP CODE:	93612
CAPACITY:	20	CENSUS: 16	DATE:	01/16/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:10 AM
MET WITH:	Theresa Avellar		TIME COMPLETED:	10:55 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	On 01/16/2020, an unannounced annual inspection was conducted by Licensing Program Analyst (LPA) Candis Rodriguez and Associate Governmental Program Analyst (AGPA) Stephanie Navarro. LPA and AGPA met with Director Theresa Avellar and toured the facility, both indoors and outdoors. LPA took a census and observed sixteen (16) children, four (4) staff and one (1) volunteer. This is an AM/PM half day program which operates on a traditional school year schedule. The morning session is 8:00am to 11:30am and the afternoon session is 12:30pm to 4:00pm, Monday through Friday. There are no bodies of water on site. Firearms/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. 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. 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. Facility is temporarily utilizing the adjacent playground while the designated playground is going through construction. 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. Areas around high climbing equipment and slides have cushioning material to absorb falls. (Continued on LIC 809-C)

SUPERVISOR'S NAME: Alice Juarez	TELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Candis Rodriguez	TELEPHONE: (559) 341-4117
LICENSING EVALUATOR SIGNATURE:	DATE: 01/16/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2020

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: FRESNO EOC CLOVIS HEAD START	FACILITY NUMBER: 100406724
	VISIT DATE: 01/16/2020

NARRATIVE

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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, no deficiencies are observed today. Site Visit Notice posted on the parent board. Exit interview was conducted with Director Theresa Avellar.

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 Juarez	TELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Candis Rodriguez	TELEPHONE: (559) 341-4117
LICENSING EVALUATOR SIGNATURE:	DATE: 01/16/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2020

LIC809 (FAS) - (06/04)

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