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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103808231
Report Date: 08/15/2019
Date Signed: 08/15/2019 02:05:29 PM

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:CD STATE PRESCHOOL-HAROLD L. WOODSFACILITY NUMBER:
103808231
ADMINISTRATOR:KIYUNA, CHARLENEFACILITY TYPE:
850
ADDRESS:700 TEAGUETELEPHONE:
(559) 327-8837
CITY:CLOVISSTATE: CAZIP CODE:
93619
CAPACITY:30CENSUS: 0DATE:
08/15/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:50 PM
MET WITH:Teacher Director, Janna MyersTIME COMPLETED:
02:30 PM
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An unannounced case management visit was conducted today by Licensing Program Analyst (LPA) Caroline Harris. Met with Teacher Director, Janna Myers and toured the facility both indoors and out doors. The facility is currently on inactive status and is going to re-activate their license effective August 20, 2019. The purpose of todays visit was to inspect the facility, so that it is ready for the school year. There are no bodies of water. Fire arms and ammunition are not on the premises. Disinfectants, hazardous items are inaccessible to children. LPA did not observe any poisons on site. Director understands if there is any poisons on site, it must be stored under lock and key. There are two toy sheds in the play yard that are locked. Furniture and equipment are sufficient, age appropriate and in good repair. The playground equipment is maintained and in good condition with adequate wood chips used as cushioning material. Children's toilets, hand washing facilities are sanitary. Rooms are safe and clean. Breakfast will be served at 9:00am in the school cafeteria. Covered storage containers for solid waste are available in the classroom. Drinking water is available both indoors and outside. Staff subject to a criminal record clearance or exemption are associated to the facility. Staff records contain documentation of education, training, and/or experience. First Aid/CPR reviewed and in compliance. Menus are posted. Hours of operation are Tuesday – Friday, 8:30am – 11:30am and follow the Clovis Unified School District calendar.

The facility currently meets the description of a safe and healthy environment for children as described in Chapter 3, Division 12, Title 22 of California Code of Regulations and is approved for a capacity of up to thirty children with an effective date of 8/20/2019. A COPY OF THIS REPORT IS TO REMAIN IN THE FACILITY FOR PUBLIC REVIEW.
To order forms, etc. visit our website at www.ccld.ca.gov
SUPERVISOR'S NAME: Alice JuarezTELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Caroline HarrisTELEPHONE: (559) 341-4624
LICENSING EVALUATOR SIGNATURE:

DATE: 08/15/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2019
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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