103801416-10-6-2023-04-CC-MHEA-CWCQFZ-20231006120847

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 103801416
Report Date: 10/04/2023
Date Signed: 10/06/2023 12:08:57 PM

Document Has Been Signed on 10/06/2023 12:08 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 RO, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME:	FUSD-ANTHONY		FACILITY NUMBER:	103801416
ADMINISTRATOR:	MATHIES, DEANNA		FACILITY TYPE:	850
ADDRESS:	1542 E. WEBSTER		TELEPHONE:	(559) 457-3690
CITY:	FRESNO	STATE: CA	ZIP CODE:	93728
CAPACITY:	24	CENSUS: 15	DATE:	10/04/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Charlotte Miranda		TIME COMPLETED:	01:15 PM

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On 10/04/2023 Licensing Program Analysts (LPA) Miguel Herrera, conducted an unannounced annual inspection. LPA met with Healthy and Safety Supervisor Charlotte Miranda. This is a single room classroom with a census of 15 children present. LPA toured the facility, both indoors and outdoors to inspect areas accessible to children in care. FUSD Anthony Preschool runs regular school schedule starting 08/17/23 to June 04, 2024 Monday through Friday from 8:00 AM to 11:00 for the morning session and 11:30 AM to 2:30 PM for the afternoon session.

LPA Herrera observed all required licensing forms to be posted in a visible location for authorized representatives to view them. 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 twelve children in attendance. Capacity and limitations as specified on the license are being maintained.

There is an electronic sign in/out system for the usage of parents and/or authorized representatives. LPA observed sign in/out sheet for the usage of parents and/or authorized representatives. The sign in/out sheet documented a full legal signature and a record of the time of day. 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. The LPA did not observe disinfectants, cleaning solutions and other dangerous items to be accessible to children. There were no poisons observed on the premises accessible to children. Licensee is aware that poisons are required to be locked and inaccessible to children.

Continued on 809-C.

SUPERVISOR'S NAME: Juvenal Moctezuma	TELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Miguel Herrera	TELEPHONE: (559) 341-0721
LICENSING EVALUATOR SIGNATURE:	DATE: 10/04/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2023

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 10/06/2023 12:08 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 RO, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: FUSD-ANTHONY	FACILITY NUMBER: 103801416
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/04/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101220(b)(2)

Child's Medical Assessments

(b) The medical assessment shall provide the following: (2) Results of a test for tuberculosis. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on LPA's observation during file review, the licensee did not comply with the section cited above due to having two children's files (child #3 and #5) missing a complete physician medical assessment with tuberculosis risk assessment clearance from physician, which poses/posed a potential health, safety, or personal rights risk to persons in care.
	POC Due Date: 10/18/2023
	Plan of Correction
1 2 3 4	Supervisor Miranda will work with the enrollment team to upload all required documents to the electronic system as soon as possible to ensure LPAs have accesses to required documents in real time.

Type B

Section Cited

CCR

101221(a)

Child's Records

(a) The licensee shall ensure that a separate, complete and current record for each child is maintained in the child care center. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on LPA's observation during file review, the licensee did not comply with the section cited above due to having two children's files (child #3 and #5) missing required licensing forms (LIC995, LIC613A), and Admission Agreement, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 10/18/2023
	Plan of Correction
1 2 3 4	Supervisor Miranda will work with the enrollment team to upload all required documents to the electronic system as soon as possible to ensure LPAs have accesses to required documents in real time.

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 Moctezuma	TELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Miguel Herrera	TELEPHONE: (559) 341-0721
LICENSING EVALUATOR SIGNATURE:	DATE: 10/04/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2023

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
FRESNO CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: FUSD-ANTHONY	FACILITY NUMBER: 103801416
	VISIT DATE: 10/04/2023

NARRATIVE

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During the inspection, LPA observed furniture and equipment that are in good condition, free of sharp, loose, or pointed parts. The facility has sufficient age-appropriate furniture, and equipment. Playground equipment is in safe condition, free of sharp, loose or pointed parts. LPA Herrera observed a leaking sprinkler near the wood chip area in the outdoor play area. LPA observed the discoloration of wood chips that had been wet for some period due to the sprinkler leakage. Supervisor Miranda was proactive and ensured a work order was submitted to fix the leak. LPA Herrera observed adequate cushioning in the form of wood chips underneath the play structure and landing of the slides to absorb falls. LPA advised to have the staff conduct frequent safety inspections of the outdoor play structure and to check for any loose parts, cracks, and hazards. Supervisor Miranda is aware of child safety around the play structure and assumes all responsibility. Supervisor Miranda understands that children must be always supervised while using the play structure.

The facility has a complete first aid kit, including bandages, scissor, thermometer, gloves and a first aid manual. All toilets and hand washing facilities are in safe and sanitary operating condition. Drinking water is available both indoors and outdoors.

All floors are clean and safe. Breakfast is served in the cafeteria for the morning session and food is brought to children in the afternoon session from the cafeteria. The food is prepared at an offsite location. All food is protected against contamination and any contaminated food is discarded immediately. Menus are posted at least one week in advance where an authorized representative can view them. The facility is free of flies, insects, and rodents. Solid waste storage containers have tight-fitting covers and are in good repair. Facility has one or more functioning carbon monoxide detectors that meet the statutory requirements. There is a working fire extinguisher 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.

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 children are at the facility or at offsite activities. 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. All children are under supervision, including visual supervision, of a teacher at all times. Facility meets teacher-child ratios. Continued on 809-C.

SUPERVISOR'S NAME: Juvenal Moctezuma	TELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Miguel Herrera	TELEPHONE: (559) 341-0721
LICENSING EVALUATOR SIGNATURE:	DATE: 10/04/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2023

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
FRESNO CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: FUSD-ANTHONY	FACILITY NUMBER: 103801416
	VISIT DATE: 10/04/2023

NARRATIVE

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LPA reviewed a sample of children’s files and observed 2 files out of 5 files were missing TB assessment/testing documentation, Personal Rights, Parent’s Rights and Admission Agreements. (See 809D) All other 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 complete with health screening, immunization records for influenza, pertussis and measles and current documentation of completed mandated reporter training.

As a condition of employment for all staff to have a fingerprint clearance through Fresno Unified School

District prior to working or volunteering in a licensed childcare 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.

LPA discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to resources such as forms, regulations Provider Information Notices (PINs), and Quarterly Updates.

LPA discussed Reporting Requirements as outlined in the regulations (Section 101212).

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1- CCP). LPA verified that the lead testing was completed in accordance with the Written Directives outlined in PIN 21-21.1-CCP. LPA referred Supervisor Miranda to the Department website for lead: www.cdss.ca.gov/inforesources/child-care-licensing/water-testing-information.

LPA discussed safe sleep regulations with Supervisor Miranda and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed the 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. To be continued on 809-C.

SUPERVISOR'S NAME: Juvenal Moctezuma	TELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Miguel Herrera	TELEPHONE: (559) 341-0721
LICENSING EVALUATOR SIGNATURE:	DATE: 10/04/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2023

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
FRESNO CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: FUSD-ANTHONY	FACILITY NUMBER: 103801416
	VISIT DATE: 10/04/2023

NARRATIVE

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Incidental Medical Services (IMS) are on file but not currently being provided based on need. For IMS
information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of
Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to
publication. Commonly Asked Questions about Child Care Centers and the ADA are available at:
https://www.ada.gov/resources/child-carecenters/.

Supervisor Miranda was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

Exit interview conducted and report was reviewed with Supervisor Miranda. Appeal rights were provided. Per the California Code of Regulations, Title 22, Division 12, Chapter 1, there are deficiencies being cited during today’s inspection. (See page LIC809-D for additional information). 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 Moctezuma	TELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Miguel Herrera	TELEPHONE: (559) 341-0721
LICENSING EVALUATOR SIGNATURE:	DATE: 10/04/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2023

LIC809 (FAS) - (06/04)

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