103801352-12-4-2019-04-CC-ROCA-BJK2KU-20191204162832

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 103801352
Report Date: 12/04/2019
Date Signed: 12/04/2019 04:28:43 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:	RIVERDALE U.S.D.PRESCHOOL/CENTRAL VALLEY PRESCHOOL		FACILITY NUMBER:	103801352
ADMINISTRATOR:	PERCELL, JEFF		FACILITY TYPE:	850
ADDRESS:	21320 SOUTH FELAND		TELEPHONE:	(559) 867-0707
CITY:	RIVERDALE	STATE: CA	ZIP CODE:	93656
CAPACITY:	57	CENSUS: 0	DATE:	12/04/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	03:15 PM
MET WITH:	Kimberly Roush		TIME COMPLETED:	04:40 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	An unannounced annual inspection was conducted today by Licensing Program Analysts (LPAs) Ruby Ocegueda and Robert Gutierrez. LPAs met with Program Director Kimberly Roush and toured the facility, both indoors and outdoors as shown on the facility sketch. There was no bodies of water on site. Firearms/weapons are not allowed or stored on premises. There were no children in care at the time of today's inspection. No poisons were observed during today’s inspection. All materials and surfaces accessible to children were toxic free. Medications are kept in elementary school nurse's office. All toilets and hand washing facilities were 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. All meals are provided in the elementary schools cafeteria. Children are walked to the cafeteria by staff. Solid waste storage vessels, including moveable bins, have tight-fitting covers on, are in good repair. Uncontaminated drinking water is available both indoors and outdoors. Menus were posted at least one week in advance, where an authorized representative can view them. Per Program Director carbon monoxide detector was tested at the beginning of this school year and was functioning. 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 wood chips to absorb falls. continue report on 809-C

SUPERVISOR'S NAME: Michael Duarte	TELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Ruby Ocegueda	TELEPHONE: (559) 341-5808
LICENSING EVALUATOR SIGNATURE:	DATE: 12/04/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2019

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: RIVERDALE U.S.D.PRESCHOOL/CENTRAL VALLEY PRESCHOOL	FACILITY NUMBER: 103801352
	VISIT DATE: 12/04/2019

NARRATIVE

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Community Care Licensing 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. Staff are fingerprinted by Riverdale Joint Unified School District as a condition of employment. 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.

Two staff records were reviewed today. At least one person trained in CPR and Pediatric first-aid is present when children are at the facility or at off-site activities. CPR expires on 8/5/21. 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.

This is an AM/PM half day program which operates on a traditional school year schedule. The morning session is 8:00 AM to 11:15 AM and the afternoon session is 11:45 AM to 2:45 PM, Monday through Friday.

Required CCL forms are posted on parent's board.

This facility provides Incidental Medical Services – IMS. LPA's reviewed child's file that contained IMS plan documentation. Medication could not be inspected today as its the facility policy to store medication in nurse's office and was not available for LPA's to inspect due to time of todays inspection. LPA's reminded director Roush to review medication for expiration dates and proper storage.

Per Chapter 1, Division 12, Title 22 of the California Code of Regulations no deficiencies were observed today. Site Visit Notice posted on the parent board. Exit interview was conducted with Kimberly Roush.

SUPERVISOR'S NAME: Michael Duarte	TELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Ruby Ocegueda	TELEPHONE: (559) 341-5808
LICENSING EVALUATOR SIGNATURE:	DATE: 12/04/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2019

LIC809 (FAS) - (06/04)

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