103801685-9-26-2019-04-CC-LGAN-BGDPF4-20190926111608

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 103801685
Report Date: 09/26/2019
Date Signed: 09/26/2019 11:16:14 AM

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:	CHILD DEVELOPMENT STATE PRESCHOOL DRY CREEK		FACILITY NUMBER:	103801685
ADMINISTRATOR:	KIYUNA, CHARLENE		FACILITY TYPE:	850
ADDRESS:	8098 N ARMSTRONG		TELEPHONE:	(559) 327-9186
CITY:	CLOVIS	STATE: CA	ZIP CODE:	93611
CAPACITY:	30	CENSUS: 12	DATE:	09/26/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	10:15 AM
MET WITH:	Lead Teacher - Jenny Sanders		TIME COMPLETED:	11:35 AM

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) Luisa Gavoutian and Candis Rodriguez. LPAs met with Lead Teacher Jenny Sanders and toured the facility, both indoors and outdoors. This facility is located on the Dry Creek Elementary School campus. There are no bodies of water on site. Firearms/weapons are not allowed or stored on premises. 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. Disinfectants, cleaning solutions and other dangerous items are inaccessible to children. No poisons were observed during today’s inspection. All materials and surfaces accessible to children are toxic free. No medications were observed during today’s inspection. All toilets, hand washing, and bathing facilities are 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. Facility has one or more functioning carbon monoxide detectors that meet statutory requirements. All meals are prepared in the school cafeteria. All kitchen, food prep, and storage areas are clean, free of litter, rubbish, and rodents/vermin. All food is protected from contamination, and contaminated food is discarded immediately. Solid waste storage vessels, including moveable bins, have tight-fitting covers, and are in good repair. Uncontaminated drinking water is available both indoors and outdoors. All foods/beverages capable of rapid spoiling are stored in covered containers at 45 (F) or less. Menus are posted at least one week in advance, where an authorized representative can view them. 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, swings, and slides have cushioning material in the form of wood chips to absorb falls. (Continued on next page, LIC809-C)

SUPERVISOR'S NAME: Alice Juarez	TELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Luisa Gavoutian	TELEPHONE: (559) 341-4725
LICENSING EVALUATOR SIGNATURE:	DATE: 09/26/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2019

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 2

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: CHILD DEVELOPMENT STATE PRESCHOOL DRY CREEK	FACILITY NUMBER: 103801685
	VISIT DATE: 09/26/2019

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
26
27
28
29
30
31
32

Community Care Licensing (CCL) 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. Before working or volunteering in a licensed child care facility, all individuals subject to a criminal record review have a clearance through Clovis Unified School District. Staff records contain appropriate documentation of education credits. At least one person trained in CPR and Pediatric first-aid is present when children are at the facility or at off-site activities. The person who signs the child in/out, is responsible for the child, uses his/her full legal signature and records the time of day. Child's admission agreement is available for review.

This is an AM half day program which operates on a traditional school year schedule. The morning session is 7:50am to 10:50am, Monday through Friday.

Required CCL forms are posted on parent's board.

This facility provides Incidental Medical Services – IMS. No children requiring IMS were present during today’s inspection. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

Per Chapter 1, Division 12, Title 22 of the California Code of Regulations no deficiencies are observed today. Exit interview was conducted with Lead Teacher Jenny Sanders.

THIS REPORT SHALL BE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.

LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS.

SUPERVISOR'S NAME: Alice Juarez	TELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Luisa Gavoutian	TELEPHONE: (559) 341-4725
LICENSING EVALUATOR SIGNATURE:	DATE: 09/26/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2019

LIC809 (FAS) - (06/04)

Page: 2 of 2