103808399-11-22-2019-04-CC-TMAZ-BJ6SDH-20191122124709

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 103808399
Report Date: 11/22/2019
Date Signed: 11/22/2019 12:47:15 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:	CLOVIS COMMUNITY COLLEGE C.D. LAB SCHOOL		FACILITY NUMBER:	103808399
ADMINISTRATOR:	MARQUEZ, MONICA		FACILITY TYPE:	850
ADDRESS:	10309 N WILLOW AVE		TELEPHONE:	(559) 325-5200
CITY:	FRESNO	STATE: CA	ZIP CODE:	93730
CAPACITY:	80	CENSUS: 28	DATE:	11/22/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Monica Marquez		TIME COMPLETED:	01:00 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 this date, Licensing Program Analyst (LPA) Theresa Marquez conducted an unannounced Annual inspection and met with Director Monica Marquez. LPA Marquez toured the facility, both indoors and outdoors. 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. The program consist of 3 classrooms. Two preschool classrooms and one toddler classroom. This is an AM half day and full day program which operates with the Clovis Community College school year schedule. Hours of operation are Monday, 7:30 AM – 4:00 PM and Tuesday-Friday, 7:30 AM – 5:30 PM. Required CCL forms are posted on parent's board. Furniture and equipment are in good condition. All materials and surfaces accessible to children are toxic free. All floors are clean and safe. The facility provides am AM and PM snack. All kitchen, food prep, and storage areas are clean, free of litter, rubbish, and rodents/vermin. Snack menus are posted at least one week in advance, where an authorized representative can view them. All toilets and hand washing facilities are in safe and sanitary operating conditions. Medications are stored in a locked cabinet in the kitchen area and inaccessible to children. No poisons were observed during today’s inspection. Playground equipment is in good condition. Areas around high climbing equipment, swings, and slides have cushioning material to absorb falls. Uncontaminated drinking water is available both indoors and outdoors. There are no bodies of water on site. Firearms/weapons are not allowed or stored on premises. Facility has one or more functioning carbon monoxide detectors that meet statutory requirements. Continued on LIC809-C

SUPERVISOR'S NAME: Susie Fanning	TELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Theresa Marquez	TELEPHONE: (559) 341-7123
LICENSING EVALUATOR SIGNATURE:	DATE: 11/22/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/22/2019

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: CLOVIS COMMUNITY COLLEGE C.D. LAB SCHOOL	FACILITY NUMBER: 103808399
	VISIT DATE: 11/22/2019

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

Staff records contain appropriate, documentation of education credits. Before working or volunteering in a licensed child care facility, all individuals subject to a criminal record review have a clearance or exemption and have been associated to the facility.
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 their full legal signature and records the time of day. Child's admission agreement is available for review.

This facility provides Incidental Medical Services (IMS). LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. The following information regarding Americans with Disability Act (ADA) was provided: US Department of Justice toll free ADA Information line at (800) 514-0301(voice) and (800) 514-0383 (TDD) and website link
https://www.ada.gov/childqanda.htm for Commonly Asked Questions about Child Care Centers and the ADA.The Director is to provide the updated licensing forms: LIC 500 - Personnel Report; LIC 308 Designation of Administrative Responsibility; LIC 610 Emergency Disaster Plan.

Per Chapter 1, Division 12, Title 22 of the California Code of Regulations no deficiencies are observed today.

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: Susie Fanning	TELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Theresa Marquez	TELEPHONE: (559) 341-7123
LICENSING EVALUATOR SIGNATURE:	DATE: 11/22/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/22/2019

LIC809 (FAS) - (06/04)

Page: 2 of 2