100408954-11-28-2022-04-CC-KVAG-CLLUBB-20221128142604

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 100408954
Report Date: 11/28/2022
Date Signed: 11/28/2022 02:26:21 PM

Document Has Been Signed on 11/28/2022 02:26 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
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME:	FUSD-EWING		FACILITY NUMBER:	100408954
ADMINISTRATOR:	MADDEN, KATHERINE		FACILITY TYPE:	850
ADDRESS:	4873 E. OLIVE		TELEPHONE:	(559) 457-3690
CITY:	FRESNO	STATE: CA	ZIP CODE:	93727
CAPACITY: 45	TOTAL ENROLLED CHILDREN: 45	CENSUS:	DATE:	11/28/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Maria Barba		TIME COMPLETED:	02:30 PM

NARRATIVE

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On 11/28/2022, Licensing Program Analysts (LPAs) Ka Vang and Araceli Gibson conducted an unannounced Annual Required Inspection and was met by teacher for Classroom 32A, and Teacher for Classroom 19. This preschool operates from August to June in Rooms 19 and 32A; both classrooms have an AM and PM sessions. AM session starts from 8:00 AM to 11:00 AM, and PM session starts from 12:00 PM to 3:00 PM. Breakfast and lunches are provided in the cafeteria by parent escort prior to the start of each session for AM and PM.

LPAs toured the facility indoors and outdoors, and a census was taken. In Classroom 32A, there are 17 children and 3 teachers. In Classroom 19, there are 14 children with 3 staff. 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. 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 to children. No poisons were observed during the inspection.

During the inspection, LPA observed furniture and equipment are in good condition, free of sharp, loose, or pointed parts. LPAs observed 2 out of 4 tricycles needed maintenance to the handles. Teacher put the bikes away until repairs can be made to ensure safety. All toilets and handwashing facilities are in safe and in operating condition. LPA discussed safety and sanitary best practices regarding paper towel dispensers in working and clean order. All floors are clean and safe. LPAs discussed as a best practice wood chips should be raked regularly to ensure high impact areas are cushioned for daycare children. The facility is free of flies, insects, and rodents. Facility has one or more functioning carbon monoxide detectors that meet the statutory requirements. Solid waste storage containers have tight-fitting covers and are in good repair. Drinking water is available both indoors and outdoors.

(Continued on LIC 809-C)

Michael Duarte
Ka Vang
	DATE: 11/28/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/28/2022

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 11/28/2022 02:26 PM - It Cannot Be Edited

Created By: Ka Vang On 11/28/2022 at 12:44 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

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

FACILITY NAME: FUSD-EWING	FACILITY NUMBER: 100408954
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 11/28/2022

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
1 2 3 4	During record reviewed, three out of the six staff are missing their current immunization record. Staff 2 (S2), Staff 5 (S5) and Staff 6 (S6) did not have their current immunization records in file which posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 12/16/2022
	Plan of Correction
1 2 3 4	Classroom 32A Staff 1 (S1) agree to submit proof of immunization for S2 by POC 12/16/2022. Classroom 19 Staff 4 (S4) agree to submit proof of immunization records for S5 and S6 by POC 12/16/2022.

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	During record reviewed, four of six staff did not have current mandated reporter training (AB 1207). Staff 1 (S1), Staff 2 (S2), Staff 3 (S3), Staff 5 (S5) and Staff 6(S) did not have their current AB 1207 in file which posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 12/16/2022
	Plan of Correction
1 2 3 4	Classroom 32A Staff 1 (S1) agree to submit proof of mandated reporter training (AB 1207) for S1, S2 and S3 by POC due date. Classroom 19 Staff 4 (S4) agree to submit proof of complete mandated reporter training for S5 and S6 by POC due date.

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

LICENSING EVALUATOR NAME:

Ka Vang

LICENSING EVALUATOR SIGNATURE:

DATE: 11/28/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/28/2022

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-EWING	FACILITY NUMBER: 100408954
	VISIT DATE: 11/28/2022

NARRATIVE

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There is a working fire extinguisher, smoke detector, carbon monoxide detector and adequate heating and ventilation for safety and comfort. Fire drills are conducted and documented with the date, time and how many children present, every six months.

All employees and volunteers, must obtain a criminal record clearance or exemption, prior to working at this facility through Fresno Unified School District.

At least one person trained in CPR and Pediatric First Aid is present when children are at the facility or at off site activities. During record reviewed 4 out of 6 Staff files did not have current mandated child abuse reporting training as a result, a citation of Type B was issued. 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.

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 inconsistent with health screening, 3 out of 6 Staff files did not have immunization records for influenza, pertussis and measles. See 809D type B issued.

Incidental Medical Services (IMS) policy was discussed. Facility is providing IMS to children in care. For IMS information see Evaluator Manual-Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (8008) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/childqanda.htm.

(Continued on LIC809-C).

SUPERVISOR'S NAME: Michael Duarte
LICENSING EVALUATOR NAME: Ka Vang
LICENSING EVALUATOR SIGNATURE:	DATE: 11/28/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/28/2022

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-EWING	FACILITY NUMBER: 100408954
	VISIT DATE: 11/28/2022

NARRATIVE

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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.

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.

Per the California Code of Regulations, Title 22, Division 12, Chapter 1, there are deficiencies been cited during today’s inspection. (see next page, 809 D).

Facility representative was provided a copy of appeal rights. A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with facility representative Renee White.

SUPERVISOR'S NAME: Michael Duarte
LICENSING EVALUATOR NAME: Ka Vang
LICENSING EVALUATOR SIGNATURE:	DATE: 11/28/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/28/2022

LIC809 (FAS) - (06/04)

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