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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103801353
Report Date: 12/01/2022
Date Signed: 12/01/2022 04:56:56 PM

Document Has Been Signed on 12/01/2022 04:56 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:CAMPUS CHILDREN'S CENTER - SITE IIIFACILITY NUMBER:
103801353
ADMINISTRATOR:RANDOLPH, BRITTNEYFACILITY TYPE:
830
ADDRESS:5150 N CAMPUS DRTELEPHONE:
(559) 278-0225
CITY:FRESNOSTATE: CAZIP CODE:
93740
CAPACITY: 22TOTAL ENROLLED CHILDREN: 22CENSUS: 12DATE:
12/01/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Brittney RandolphTIME COMPLETED:
05:30 PM
NARRATIVE
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On December 1, 2022 Licensing Program Analyst (LPA) C Brannon, conducted an unannounced Annual Required Inspection for the infant license. LPA met with Director, Brittany Randolph, and toured the facility indoors and outdoors. Days and hours of operation are Monday through Friday, 7:30 AM to 5:30 PM. Director verified facility phone number is (559) 278-0225. During today’s inspection, the infants did not go outside to play due to the cold weather and rain. LPA observed two infant rooms with a total of 12 infants being cared for by 6 staff.

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 today's inspection.

Furniture and equipment are in good condition, free of sharp, loose or pointed parts. Playground equipment is in safe condition, free of sharp, loose or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. There are two outside play yards for infants. Both play yards utilize rubber pour as cushioning and there is adequate shade. In the older infant play yard, there is a metal pole that has been cut and duct tape is utilized to cover the metal edge. LPA was informed that a work order has been issued to have the metal pole removed. The older infant play yard has one climbing structure. There is no age appropriate sticker. LPA was informed that licensee has reached out the manufacturer and due to not making this model, the company was unable to provide an age appropriate sticker. LPA recommended for licensee to hire a playground inspector and receive the required age appropriate sticker from the inspector. There are two metal leaf rakes in the younger infant play yard, which are accessible to infants in care. In the younger infant play yard, there is a wicker couch with some wicker pieces falling or sticking out.

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SUPERVISORS NAME: Michael Duarte
LICENSING EVALUATOR NAME: Cynthia Brannon
LICENSING EVALUATOR SIGNATURE: DATE: 12/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/01/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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Document Has Been Signed on 12/01/2022 04:56 PM - It Cannot Be Edited


Created By: Cynthia Brannon On 12/01/2022 at 03:27 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: CAMPUS CHILDREN'S CENTER - SITE III
FACILITY NUMBER: 103801353

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/01/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101216(g)(2)
Personnel Requirements
(2) Each person specified in (g) above shall have a health-screening report signed by the person performing the screening. This report shall indicate the following:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA's staff record review, the licensee did not comply with the section cited above. Staff #2 and #5 are missing the required Health Exam form that includes physician's comments if staff can meet their job duties. This poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/15/2022
Plan of Correction
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Per Director, staff will provide the required completed LIC 503 Health Screening form. A copy of forms will be sent to the Fresno Community Care Licensing office no later than 12/15/22
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Cynthia Brannon
LICENSING EVALUATOR SIGNATURE:
DATE: 12/01/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/01/2022


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Document Has Been Signed on 12/01/2022 04:56 PM - It Cannot Be Edited


Created By: Cynthia Brannon On 12/01/2022 at 04:01 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: CAMPUS CHILDREN'S CENTER - SITE III
FACILITY NUMBER: 103801353

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/01/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101419.3(a)
Modifications to Infant Needs and Services Plan: The written infant needs and services plan shall be updated at least quarterly,or as often as needed. The director, assistant director or a teacher shall update the plan with the assistance of the infant's authorized representative.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA's record review, the licensee did not comply with the section cited above. LPA reviewed six infant files and observed all six files did not have the updated Needs and Services Plan. This poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/15/2022
Plan of Correction
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Per Director, staff will update infants' Needs and Services plan with authorized representatives. A copy of current completed Needs and Services plan will be sent to the Fresno Community Care Licensing office by December 15, 2022.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Cynthia Brannon
LICENSING EVALUATOR SIGNATURE:
DATE: 12/01/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/01/2022


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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: CAMPUS CHILDREN'S CENTER - SITE III
FACILITY NUMBER: 103801353
VISIT DATE: 12/01/2022
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During today's inspection, LPA observed that the crib room was too dark for staff to visually inspect sleeping infants. LPA spoke with staff and was informed that she lays her hand on the infant's chest to verify breathing. LPA requested that staff allows for more light to allow visual observation of sleeping infant.

As per Title 22, Chapter 1, section 101419.2 Infant Needs and Services Plan, prior to the infant’s first day at the center the infant care center director or assistant shall completed a needs and services plan for the infant with infant’s authorized representative and with both parties’ signatures and date. As per section 101410.3, the infant needs and services plan shall be updated at least quarterly, or as often as necessary to assure its accuracy. The authorized representative shall sign the plan to verify that he/she has participated in updating it.



Changing tables are within arm’s reach of hand washing faucet. Floors in the facility are clean and safe. All kitchen, food preparation and storage areas are clean, free of litter/rubbish and free of rodents/vermin. All food is protected against contamination and any contaminated food is discarded immediately. Solid waste storage containers have tight-fitting covers and are in good repair. Drinking water is available both indoors and outdoors. The facility is free of flies, insects and rodents. Facility has one or more functioning carbon monoxide detectors that meet statutory requirements.

Director, Brittany Randolph, was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated. 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. At least one person trained in CPR and Pediatric First Aid is present when infants are at the facility or at offsite activities. The Campus Children’s Center – Site III designated director to act on behalf of licensee has been reported to the Department.

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SUPERVISORS NAME: Michael Duarte
LICENSING EVALUATOR NAME: Cynthia Brannon
LICENSING EVALUATOR SIGNATURE:

DATE: 12/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2022
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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: CAMPUS CHILDREN'S CENTER - SITE III
FACILITY NUMBER: 103801353
VISIT DATE: 12/01/2022
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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. Facility maintains a ratio of one teacher supervising no more than 4 infants in care.

LPA reviewed a sample of staff files. Menus are posted at least one week in advance where an authorized representative can view them.

Per Director, Brittany Randolph, CSU Fresno provides free flu vaccinations but does not provide proof of vaccination. Staff still completes the Annual Flu Declination Statement; however, the current flu declination was not in staff files. One staff is missing current AB120. Staff #2 and #5 are missing the LIC 503, that includes exam, signature, qualifies to perform assigned job duties

Currently, facility is not providing Incidental Medical Services.



LPA discussed the safe sleep regulations with Director, Brittany Randolp, and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed director of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

LPA and director 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.

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SUPERVISORS NAME: Michael Duarte
LICENSING EVALUATOR NAME: Cynthia Brannon
LICENSING EVALUATOR SIGNATURE:

DATE: 12/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2022
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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: CAMPUS CHILDREN'S CENTER - SITE III
FACILITY NUMBER: 103801353
VISIT DATE: 12/01/2022
NARRATIVE
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Per Title 22, Division 12, Chapter 1, 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.

Exit interview conducted and report was reviewed with director, Brittany Randolph.

This report shall be made available to the public upon request. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISORS NAME: Michael Duarte
LICENSING EVALUATOR NAME: Cynthia Brannon
LICENSING EVALUATOR SIGNATURE:

DATE: 12/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2022
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