103801881-8-31-2022-04-CC-SGAN-CHTMZ4-20220831100230

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 103801881
Report Date: 08/30/2022
Date Signed: 08/31/2022 10:02:39 AM

Document Has Been Signed on 08/31/2022 10:02 AM - 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, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME:	CHILD DEVELOPMENT-STATE PRESCHOOL-RED BANK		FACILITY NUMBER:	103801881
ADMINISTRATOR:	KIYUNA, CHARLENE		FACILITY TYPE:	850
ADDRESS:	1454 N LOCAN		TELEPHONE:	(559) 327-7885
CITY:	CLOVIS	STATE: CA	ZIP CODE:	93619
CAPACITY:	22	CENSUS: 17	DATE:	08/30/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:00 AM
MET WITH:	Teacher/Director, Amy Dolan		TIME COMPLETED:	11:00 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	On 8/30/2022, Licensing Program Analyst (LPA) Stefanie Galvan, conducted an unannounced Annual Inspection. LPA met with Director/Teacher, Amy Dolan. LPA toured the facility indoors and outdoors. During today’s inspection there were 17 children in care and 3 staff members. This is an AM half day program which operates on a traditional school year schedule. The morning session is 8:00 a.m. to 11:00 a.m., Monday – Friday. 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. No poisons were observed during the inspection. Furniture and equipment are in good condition, free of sharp, loose, or pointed parts. All toilets and handwashing facilities are in safe and sanitary operating condition. All floors are clean and safe. The facility is free of flies, insects and rodents. Facility did not have one or more functioning carbon monoxide detectors that meet statutory requirements. Breakfast is served to the children from the school cafeteria. Snacks are provided as needed inside the classroom. All kitchen, food preparation, and storage areas are clean, free of litter/rubbish and 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. Uncontaminated drinking water is available both indoors and outdoors. Menus are posted at least one week in advance where an authorized representative can view them. 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. Areas around high climbing equipment, swings, and slides have cushioning material in the form of wood chips to absorb falls. continued on 809-C

SUPERVISOR'S NAME: Diana deLeon	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Stefanie Galvan	TELEPHONE: (559) 341-5431
LICENSING EVALUATOR SIGNATURE:	DATE: 08/30/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2022

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 08/31/2022 10:02 AM - 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, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: CHILD DEVELOPMENT-STATE PRESCHOOL-RED BANK	FACILITY NUMBER: 103801881
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/30/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.954

Licensure Requirements

Every licensed child day care center shall have one or more carbon monoxide detectors in the facility that meet the standards established in Chapter 8 (commencing with Section 13260) of Part 2 of Division 12. The department shall account for the presence of these detectors during inspections. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 09/08/2022
	Plan of Correction
1 2 3 4	Facility Director to submit a work order for maintenance to install a carbon monoxide detector in the portable classroom, then send LPA proof that it has been installed.

Type B

Section Cited

CCR

101229.1(b)

Sign In and Sign Out

(b) The person who brings the child to, and removes the child from, the center shall sign the child in/out. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in 2 out of 17 children. One child was signed out before completing the day and one child was not signed in for the current day, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 09/08/2022
	Plan of Correction
1 2 3 4	Facility to send a notice to all parents to remind them that sign in and sign outs for children must be done accurately each day. A copy of this letter shall be sent to CCL office.

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: Diana deLeon	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Stefanie Galvan	TELEPHONE: (559) 341-5431
LICENSING EVALUATOR SIGNATURE:	DATE: 08/30/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2022

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

FACILITY NAME: CHILD DEVELOPMENT-STATE PRESCHOOL-RED BANK	FACILITY NUMBER: 103801881
	VISIT DATE: 08/30/2022

NARRATIVE

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Employees and/or volunteers are subject to criminal background clearance by Clovis Unified School District before working or volunteering in a licensed childcare facility, all individuals subject to a criminal record review have a clearance or exemption and have been associated to the facility. 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. Capacity and limitations as specified on the license are being maintained. At least one person trained in Pediatric CPR and First Aid is present when children are at the facility or at offsite activities. The name of the childcare 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 uses their full legal signature and records the time of day. LPA observed one child who was signed out for the current day before the day was over and one child who had not been signed in or out for today’s date. LPA reviewed a sample of children’s files and observed files were complete with contact information for authorized representatives or others who can assume responsibility if the authorized representative cannot be reached. LPA observed that all children’s files contained a 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.
This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. Information regarding Americans with Disability Act (ADA) can be obtained by contacting US Department of Justice toll free ADA Information line at (800) 514-0301(voice), (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm.
LPA and Director discussed the CCL website (www.ccld.ca.gov) which provides 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.
Per Chapter 1, Division 12, Title 22 of the California Code of Regulations, the following deficiencies were found: (see LIC809-D). Exit interview was conducted with Amy Dolan. Director was provided a copy of appeal rights.A notice of site visit was given and must remain posted for 30 days.
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.

SUPERVISOR'S NAME: Diana deLeon	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Stefanie Galvan	TELEPHONE: (559) 341-5431
LICENSING EVALUATOR SIGNATURE:	DATE: 08/30/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2022

LIC809 (FAS) - (06/04)

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