103808033-9-1-2022-04-CC-CHAS-CHUSCW-20220901134613

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 103808033
Report Date: 09/01/2022
Date Signed: 09/01/2022 01:46:30 PM

Document Has Been Signed on 09/01/2022 01:46 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, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME:	WEST FRESNO PRESCHOOL		FACILITY NUMBER:	103808033
ADMINISTRATOR:	SHARP, ANNIE		FACILITY TYPE:	850
ADDRESS:	2888 S. IVY AVENUE		TELEPHONE:	(559) 495-5606
CITY:	FRESNO	STATE: CA	ZIP CODE:	93706
CAPACITY:	48	CENSUS: 32	DATE:	09/01/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:20 AM
MET WITH:	Liliana Rubio		TIME COMPLETED:	02:30 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	On 9/1/22 Licensing Program Analyst (LPA) Caroline Harris made an unannounced annual inspection. LPA met with Site Supervisor, Liliana Rubio. A census was taken. LPA toured the facility inside and outside as shown on the facility scetches. LPA observed all required licensing forms to be posted in a visible location for authorized representatives to view them. This facility follows the regular school district schedule and runs two half day programs. The AM session is from 8:00AM to 11:00AM and PM session is from 11:30 PM to 2:30 PM. Breakfast is provided to the AM session and lunch is provided to the PM session, and meals are eaten at the elementary 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 on, are in good repair.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. Firearms/weapons or ammunition are not allowed or stored on the 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. During the inspection, the LPA observed Lysol wipes, sharp scissors, hand sanitizers, sharpie markers and other keep out of reach items to be down low and 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. All materials and surfaces accessible to children are toxic free. Furniture and equipment are in good condition, free of sharp, loose, or pointed parts. There is a working fire extinguisher, smoke detector, carbon monoxide indicator, and adequate heating and ventilation for safety and comfort. The licensee has a complete first aid kit, including bandages, scissor, thermometer, gloves and a first aid manual. Uncontaminated drinking water is available both indoors and outdoors.

SUPERVISOR'S NAME: Juvenal Moctezuma	TELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Caroline Harris	TELEPHONE: (559) 341-4624
LICENSING EVALUATOR SIGNATURE:	DATE: 08/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2022

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 09/01/2022 01:46 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, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: WEST FRESNO PRESCHOOL	FACILITY NUMBER: 103808033
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/01/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101238.3(b)

Indoor Activity Space

(b) The floors of all rooms shall have a surface that is safe and clean. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	During the inspection, the LPA observed in room #1, the carpet area was buckling and was a tripping hazard. This poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 09/15/2022
	Plan of Correction
1 2 3 4	The LPA spoke to the maintenance men and the carpet will be re-stretched.

Type B

Section Cited

CCR

101238(a)

Buildings and Grounds

(a) The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	LPA observed the ceiling vents in the classrooms to be dirty and dirt/dust was spread on the ceiling. In the bathroom, the LPA observed the caps that cover the bolts at the bottom of the toilets to be missing and there were two ceiling tiles to be sagging. This poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 09/15/2022
	Plan of Correction
1 2 3 4	The LPA spoke to the maintenance men and they will clean the vents, put caps on the bolts at the bottom of the toilets and fix the ceiling tiles.

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: Caroline Harris	TELEPHONE: (559) 341-4624
LICENSING EVALUATOR SIGNATURE:	DATE: 09/01/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/01/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 09/01/2022 01:46 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, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: WEST FRESNO PRESCHOOL	FACILITY NUMBER: 103808033
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/01/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101238(g)

Buildings and Grounds

(g) Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children shall be stored where inaccessible to children. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	The LPA observed Lysol wipes, sharp scissors, hand sanitizers, sharpie markers and other keep out of reach items to be down low and accessible to children. This poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 09/01/2022
	Plan of Correction
1 2 3 4	The staff moved all keep out of reach items up and made them out of reach. The Site Supervisor spoke to her staff about the items.

Type B

Section Cited

CCR

101217(a)

Personnel Records

(a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information: This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	The center did not have complete staff files available for review, including Mandated Reporter training's, CPR/first aid certificates, LIC forms, transcripts, etc. This poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 09/15/2022
	Plan of Correction
1 2 3 4	The LPA spoke to the center director and gave her a list of what is required to be in each staff file. The director agrees to have complete staff files available for review by the due date of 9/15/22. A return visit will take place in order to clear this deficiency.

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: Caroline Harris	TELEPHONE: (559) 341-4624
LICENSING EVALUATOR SIGNATURE:	DATE: 09/01/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/01/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 09/01/2022 01:46 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, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: WEST FRESNO PRESCHOOL	FACILITY NUMBER: 103808033
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/01/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

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	The center did not have complete children's files available for review. This poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 09/15/2022
	Plan of Correction
1 2 3 4	The LPA spoke to the director who agrees to have complete children's files available for review by the due date of 9/15/22. The LPA provided the director a list of what is required to be in each child's file. A return visit will take place to clear this deficiency.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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: Caroline Harris	TELEPHONE: (559) 341-4624
LICENSING EVALUATOR SIGNATURE:	DATE: 09/01/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/01/2022

LIC809 (FAS) - (06/04)

Page: 4 of 10

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: WEST FRESNO PRESCHOOL	FACILITY NUMBER: 103808033
	VISIT DATE: 09/01/2022

NARRATIVE

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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 to absorb falls. There were no bodies of water on site. The licensee 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. There are no excluded individuals present at this facility. Licensee is aware that upon notice from the Department, any excluded individual must be immediately removed from the facility and prevented from returning to the center or having contact with children in care. The licensee shall comply with the notice. The center did not have complete staff files available for review, including Mandated Reporter training's, CPR/first aid certificates, LIC forms, transcripts, etc. Information on Lead Poisoning was provided to the licensee and she was informed that the information is required to be posted on the parent board. The LPA and licensee discussed the Community Care Licensing website: www.ccld.ca.gov. which provides access to Provider Information Notifications (PINS), Quarterly Updates that inform licensees of new legislation and regulations, training's, and Licensing forms and updated information. The licensee was also advised that it is her responsibility to stay current with regulations. Fire drills are conducted and documented with the date, time and how many children present, every six months. The person, who signs the child in/out, is responsible for the child, uses their full legal signature and records the time of day. The center did not have complete children's files available for review. Incidental Medical Services (IMS) policy was discussed. This facility currently does not have anyone needing Incidental Medical Services (IMS). The licensee is aware that an IMS plan is required to be submitted to the licensing office if they choose to provide any of these services.

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, the following deficiencies are found: (see LIC809-D). An exit interview was conducted and a copy of this report (along with appeal rights) was provided and reviewed with Liliana Rubio. This report shall be made available to the public upon request. The LIC 9213 Notice Of Site Visit form was given to Ms. Rubio 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: Juvenal Moctezuma	TELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Caroline Harris	TELEPHONE: (559) 341-4624
LICENSING EVALUATOR SIGNATURE:	DATE: 09/01/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/01/2022

LIC809 (FAS) - (06/04)

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