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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 100407171
Report Date: 03/15/2023
Date Signed: 03/15/2023 01:43:27 PM


Document Has Been Signed on 03/15/2023 01:43 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:FUSD-MUIRFACILITY NUMBER:
100407171
ADMINISTRATOR:MATHIES, DEANNAFACILITY TYPE:
850
ADDRESS:410 E. DENNETTTELEPHONE:
(559) 457-3690
CITY:FRESNOSTATE: CAZIP CODE:
93728
CAPACITY:22CENSUS: 6DATE:
03/15/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Rosa ContrerasTIME COMPLETED:
02:00 PM
NARRATIVE
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On 03/15/23, Licensing Program Analysts (LPAs) Araceli Gibson and Martha De Haro, conducted an unannounced annual inspection. LPAs met with Teacher Rosa Contreras. They operate for two sessions for preschool from 8:00 AM to 11:00 AM for the morning session and from 11:00 AM to 2:00 PM for the PM session, Monday through Friday. During today’s inspection there was a census of 6 children in the morning class and 7 for the afternoon class. LPAs toured the classroom inside and out for areas accessible to children in care.

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.

Playground, furniture and equipment need to be monitored specifically the slide which has a small area of cracked edge that may be sharp enough to catch on children's clothing. Play structures to be monitored of loose or pointed parts. The surface of the outdoor activity space is maintained in monitored for hazards. All toilets and handwashing facilities are in safe and sanitary operating condition. LPAs observed floors/carpets in need of shampooing and there were uneven floor surfaces throughout the facility, which should be monitored for hazards (see 809-D). LPAs had a discussion about the need for solid waste storage containers to have tight-fitting covers and in good repair. LPAs observed unsanitary equipment for diapering in the children’s bathroom (see 809-D for further). Drinking water is available both indoors and outdoors. Areas around high climbing equipment, swings and slides have cushioning material to absorb falls. The facility is free of flies, and rodents. Facility has one or more functioning carbon monoxide detectors that meet statutory requirements. As a condition of employment for is for all staff to have a fingerprint clearance through Fresno Unified School District prior to working or volunteering in a licensed child care facility, all individuals subject to a criminal record review have received a criminal record clearance or exemption. Upon notification from the Department, the licensee will comply and act immediately to terminate the employment of, remove from the facility or bar from entering the facility for any person it is deemed necessary while the Department considers granting or denying an exemption. Capacity and limitations as specified on the license are being maintained. continue 809C

SUPERVISOR'S NAME: Juvenal MoctezumaTELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Araceli GibsonTELEPHONE: (559) 341-5155
LICENSING EVALUATOR SIGNATURE:
DATE: 03/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/15/2023
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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Document Has Been Signed on 03/15/2023 01:43 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-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710


FACILITY NAME: FUSD-MUIR
FACILITY NUMBER: 100407171

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/15/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101238.3(b)
Indoor Activity Space
(b) The floors of all rooms shall have a surface that is safe and clean.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observations, the licensee did not comply with the section cited above LPAs observed carpet in need of shampooing spotting on carpet, and uneven flooring throughout the facility, areas of sponginess cracked flooring which may need to be monitored for tripping hazards, which poses a potential health, safety or personal rights risk to persons in care.photos were taken.
POC Due Date: 04/17/2023
Plan of Correction
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Licensee agrees to request to have the carpets to be shampood and request a work order to have the floors inspected by maintenance for possible repair. .
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
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Based on observation, the licensee did not comply with the section cited above LPAs observed a few areas of concern the play struction has a cracked rough edge at the top of the slide in need of repair and a makeshift changing area with a fabric cushion for a lounge chair, not designated for changing diapers, with a used liner exposed. One enrolled child in need of diapering daily, also cieling tiles warped with exposed fiberglass insullation, and high toiiet screws needing caps which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/17/2023
Plan of Correction
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Licensee agrees to request work orders for all repairs and submit photos of toilet caps, replacement cieling tiles, and appropriate diapering equipment and will agree to send photo evidence of the replacement or repair of items cites by plan of correction date, 04/17/2023.
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: Juvenal MoctezumaTELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Araceli GibsonTELEPHONE: (559) 341-5155
LICENSING EVALUATOR SIGNATURE:
DATE: 03/15/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/15/2023
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 03/15/2023 01:43 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-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710


FACILITY NAME: FUSD-MUIR
FACILITY NUMBER: 100407171

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/15/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.7995(a)(1)
General Provisions and Definitions
(1) 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 is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above Staff 1 had no evidence of immunization of Pertussis, Measles or TB, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/17/2023
Plan of Correction
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Licensee agrees to have staff1 provide evidence of the immunizations Pertussis and Measle, TB test by Plan of correction date 4/17/23.
Type B
Section Cited
CCR
101223(b)(1)
Personal Rights
(1) The center shall give each authorized representative a copy of the Personal Rights form (LIC 613A [9/96]).

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above children's filed reviewed had no evidence of signed by authorized representative LIC 613A or Parents rights forms on file which posesa potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/17/2023
Plan of Correction
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Licnesee agrees to have all children's authroized representatives sign forms 613A and Parents rights by plan of correction date 4/17/23.
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: Juvenal MoctezumaTELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Araceli GibsonTELEPHONE: (559) 341-5155
LICENSING EVALUATOR SIGNATURE:
DATE: 03/15/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/15/2023
LIC809 (FAS) - (06/04)
Page: 3 of 5


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: FUSD-MUIR
FACILITY NUMBER: 100407171
VISIT DATE: 03/15/2023
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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 designated to act in the director’s absence has been reported to the Department. This facility uses the Learning Genie to maintain signing children in/out of the facility by authorized representatives at the site. 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 when in person learning is conducted. LPAs reviewed a sample of children’s files and observed files were missing Parents Rights and Personal Rights forms (see 809-D). Files did have contact information for authorized representative and or relatives or others who can assume responsibility for the child and medical assessment. LPAs reviewed the staff files and observed one staff member was missing immunization records for TB, pertussis and measles (see 809-D). Menus are posted at least one week in advance where an authorized representative can view them.

Incidental Medical Services (IMS) is not being currently being provided. 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.



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.

Per Title 22, Division 12, Chapter 3, 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: Juvenal MoctezumaTELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Araceli GibsonTELEPHONE: (559) 341-5155
LICENSING EVALUATOR SIGNATURE:

DATE: 03/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2023
LIC809 (FAS) - (06/04)
Page: 5 of 5