100407038-4-24-2023-04-CC-JPAO-CR7SSA-20230424140736

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 100407038
Report Date: 04/24/2023
Date Signed: 04/24/2023 02:07:46 PM

Document Has Been Signed on 04/24/2023 02:07 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-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME:	FIREBAUGH-LAS DELTAS UNIFIED SCHOOL DISTRICT		FACILITY NUMBER:	100407038
ADMINISTRATOR:	SANCHEZ, DELIA M.		FACILITY TYPE:	850
ADDRESS:	1691 Q ST		TELEPHONE:	(559) 659-3117
CITY:	FIREBAUGH	STATE: CA	ZIP CODE:	93622
CAPACITY:	144	CENSUS: 45	DATE:	04/24/2023
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	11:45 AM
MET WITH:	Pamela Serna - Director		TIME COMPLETED:	02:15 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 4/24/23, Licensing Program Analyst (LPA) Joseph Pacheco conducted an unannounced Case Management inspection and met with Director, Pamela Serna and toured the facility both inside and outside. Licensee is decreasing their preschool capacity from 144 to 100 preschool children. This program operates on a traditional school year schedule with full day and part day options. Full day is Monday – Friday, 6:45am – 5:30pm. Part day is Monday – Friday, 8:00am – 11:30am. Breakfast, lunch, AM snack and PM snack are provided. Food is prepared at the Hazel Bailey Elementary school cafeteria and delivered daily. The facility plans to utilize Classrooms 26 through 30. LPA measured all classrooms except Classroom 30 which was not set up and ready to provide care to preschool children. Licensee plans to utilize Classroom 30 to care for children who are two years old. Currently facility cares for children starting at age 3. Adequate storage space is available for children's belongings. A return inspection will be needed so that measurements can be taken of Classroom 30. Ill children and staff will utilize the staff bathroom located next to the outdoor play area utilized by Classrooms 28 through 30. Ill children will be isolated in the nurse’s office. Outdoor measurements were not taken during today's inspection. Licensee is decreasing capacity. Adequate shade is available in the two outdoor activity areas. One playground is utilized by Classrooms 26 & 27 and the other playground is utilized by Classrooms 28, 29, & 30. The applicant is using wood chips for cushioning under the outdoor climbing structures in both areas. The play structure and play equipment in both areas appeared to be age appropriate. There are a total of 10 toilets and 14 sinks/hand washing fixtures which will accommodate the requested capacity of 100 preschool children. All bathrooms are located outside the respective classrooms. Staff escorts children to and from the bathroom. Licensee is utilizing water dispensers located inside each classroom to fill up children’s water bottles they bring from home during indoor activities. LPA observed drinking fountains in the outdoor play area utilized by Classrooms 28 through 30. Director said children in Classrooms 26 & 27 are escorted inside the classroom to refill their water bottles during outdoor play. LPA informed Director of Title 22 regulations that water from a non-contaminated fixture shall be readily available in both indoor and outdoor activity spaces and that children shall be free to drink as they wish. CONTINUED ON LIC809-C

SUPERVISOR'S NAME: Juvenal Moctezuma	TELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Joseph Pacheco	TELEPHONE: (559) 341-4457
LICENSING EVALUATOR SIGNATURE:	DATE: 04/24/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2023

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
FRESNO-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: FIREBAUGH-LAS DELTAS UNIFIED SCHOOL DISTRICT	FACILITY NUMBER: 100407038
	VISIT DATE: 04/24/2023

NARRATIVE

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Director stated she will discuss with Licensee about getting a water pitcher or igloo jug for use during outdoor activities.
The fire clearance for preschool children ages 2-6 has been received and approved by the Firebaugh Fire Department for 100 preschool children on 3/31/23. Licensee is providing Incidental Medical Services at this facility.

The following items will need to be completed prior to an updated license being issued:

Inside Activity Area
· Cubbies in all classrooms will need to be anchored to prevent tipping.
· Classroom 30 will need to be cleaned and arranged in a way so that it’s ready to provide care and supervision.

Outdoor Activity Area
· Come up with a plan to make drinking water available in the outdoor play area utilized by Classrooms 26 & 27.

Pending a final file review and completion of the above items, the new license will reflect the decrease of the preschool capacity from 144 to 100 preschool children.

No deficiencies cited during today's visit.

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.

CONTINUED ON LIC809-C

SUPERVISOR'S NAME: Juvenal Moctezuma	TELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Joseph Pacheco	TELEPHONE: (559) 341-4457
LICENSING EVALUATOR SIGNATURE:	DATE: 04/24/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2023

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
FRESNO-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: FIREBAUGH-LAS DELTAS UNIFIED SCHOOL DISTRICT	FACILITY NUMBER: 100407038
	VISIT DATE: 04/24/2023

NARRATIVE

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The following documents should be posted at the facility:
* PUB 269- Child passenger restraint systems poster 101225(f) Transportation
* Pub 393- Notification of Parents Rights 101218.1(c) Admission Procedures
* License 101160(a) License
* Menus 101227(a)(6) Food Services
* LIC 613A- Personal Rights form 101223(b)(2) Personal Rights
* LIC 610- Disaster Plan 101174(a)
* LIC 9148- Earthquake Preparedness Checklist 101174(b)
* Activity Schedule
* Lead Poisoning brochure

To order forms, etc. visit our website at www.ccld.ca.gov.

SUPERVISOR'S NAME: Juvenal Moctezuma	TELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Joseph Pacheco	TELEPHONE: (559) 341-4457
LICENSING EVALUATOR SIGNATURE:	DATE: 04/24/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2023

LIC809 (FAS) - (06/04)

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