100407171-3-11-2020-04-CC-DDMZ-BMM27H-20200311170842

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 100407171
Report Date: 03/11/2020
Date Signed: 03/11/2020 05:08:55 PM

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-MUIR		FACILITY NUMBER:	100407171
ADMINISTRATOR:	MATHIES, DEANNA		FACILITY TYPE:	850
ADDRESS:	410 E. DENNETT		TELEPHONE:	(559) 457-3153
CITY:	FRESNO	STATE: CA	ZIP CODE:	93728
CAPACITY:	22	CENSUS: 15	DATE:	03/11/2020
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Rosa Contreras		TIME COMPLETED:	01:30 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 3/11/20 an annual inspection was conducted by Licensing Program Analyst (LPA) Diana Martinez. Met with lead teacher Rosa Contreras and toured the facility. Preschool classroom is used for child care and is located in a portable on the John Muir Elementary School grounds. This facility operates a morning and afternoon class during the traditional school year. Days and hours are Monday through Friday from 8:00 AM to 11:00 AM and 11:30 AM to 2:30 PM. No bodies of water present. Firearms/weapons are not allowed or stored on premises. All children present receive direct visual supervision at all times. There is a ratio of one teacher supervising no more than 12 children in attendance. Facility is operating within the approved licensed capacity at this inspection. All disinfectants, cleaning solutions, toxic, poisonous items, and medications are inaccessible to children. All toilets, hand washing, and bathing facilities are in safe and sanitary condition. All floors are clean and safe. Furniture and equipment are in good condition, free of sharp, loose or pointed parts. Preschool does not provide meals in the classroom; however, parents have the option to escort their children to school cafeteria as breakfast and lunch are provided before and after preschool class sessions. AM and PM snacks are provided in the classroom. All food is protected from contamination, and contaminated food is discarded immediately. Solid waste storage vessels, including moveable bins, have tight fitting covers on, and are in good repair. Uncontaminated drinking water is available both indoors and out. Menus are posted at least one week in advance where an authorized representative can view them. Menus shall be dated and kept on file for 30 days and be available for review upon request. Facility has at least one functioning carbon monoxide detector that meets statutory requirements. Playground equipment is in good condition, free of sharp, loose, or pointed parts. Outdoor activity space surface is maintained in safe condition and free of hazards. Areas under/around high climbing equipment and slides have sufficient bark cushioning material to absorb falls. Licensee does not exceed the conditions, limitations, and capacity specified on the license. Before working or volunteering in a licensed child care facility, all individuals subject to a criminal record review have a clearance or exemption through Fresno County Office of Education. There are no excluded individuals present at this center. Licensee is aware that upon notice from the Department, any (See next page)

SUPERVISOR'S NAME: Michael Duarte	TELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Diana D Martinez	TELEPHONE: (559) 341-4670
LICENSING EVALUATOR SIGNATURE:	DATE: 03/11/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2020

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: FUSD-MUIR	FACILITY NUMBER: 100407171
	VISIT DATE: 03/11/2020

NARRATIVE

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excluded individual must be immediately removed from the center. Staff records contain appropriate documentation of education credits. At least one person trained in Pediatric CPR/First Aid with the expiration date of 3/2021, is present when children are at the facility or at off site activities. The responsible person who signs the child in/out uses their full legal signature and records the time of day. Child's admission agreement is available for review.

Incidental Medical Services (IMS) are 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. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. 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 discussed with lead teacher SB 792 effective 9/1/16, regarding immunization requirements for all employees and volunteers. Lead teacher was provided with PIN 20-01-CCP regarding lead testing for drinking water, and Lead Poisoning Facts brochure and PIN 19-04-CCP.

Per Title 22, Division 12, Chapter 3 of the California Code of Regulations, the following deficiency was found (see 809D):

Licensee was provided a copy of appeal rights. An exit interview conducted with lead teacher Rosa Contreras and a copy of this report was provided and discussed. A Notice of Site Visit Form (LIC 9213) was posted on parent's board and must remain posted for 30 days.

SUPERVISOR'S NAME: Michael Duarte	TELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Diana D Martinez	TELEPHONE: (559) 341-4670
LICENSING EVALUATOR SIGNATURE:	DATE: 03/11/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2020

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-MUIR	FACILITY NUMBER: 100407171
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/11/2020

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 03/27/2020 Section Cited	1 2 3 4 5 6 7	Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year. This requirement was not met as evidenced by LPA’s record review.
	1 2 3 4 5 6 7	Two para professionals did not have proof of immunization records in their files. This poses a potential risk to the health, safety, or personal rights of children in care.
	1 2 3 4 5 6 7
	1 2 3 4 5 6 7

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: Michael Duarte	TELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Diana D Martinez	TELEPHONE: (559) 341-4670
LICENSING EVALUATOR SIGNATURE:	DATE: 03/11/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2020

LIC809 (FAS) - (06/04)

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