103808399-9-21-2021-04-CC-TMAZ-C73U96-20210921152236

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 103808399
Report Date: 09/21/2021
Date Signed: 09/21/2021 03:22:42 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) 325-5240
CITY:	FRESNO	STATE: CA	ZIP CODE:	93730
CAPACITY:	80	CENSUS: 7	DATE:	09/21/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:20 PM
MET WITH:	Monica Marquez		TIME COMPLETED:	03:30 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 9/21/2021, Licensing Program Analyst (LPA) Theresa Marquez conducted an unannounced annual inspection at Clovis Commity College C.D. Lab School. LPA Marquez met with Child Development Lab School Manager, Monica Marquez, and toured the facility indoors and outdoors. 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, Tuesday, Thursday and Friday, 7:30 AM – 5:30 PM and Wednesday, 7:30 AM – 12:30 PM. The center provides AM and PM snack. Capacity and limitations as specified on the license are being maintained. The name of the child care center Director or fully-qualified teacher(s) designated to act in the Director's absence has been reported to the Department. The facility maintains a ratio of one teacher supervising no more than 12 children in care. All children are under supervision, including visual supervision, of a teacher at all times. The person who signs the child in/out of the facility shall use their full legal signature and record the time of day Floors in the facility were clean and safe. Furniture and equipment were in good condition, free of sharp, loose or pointed parts. Children's toilets and hand washing facilities were sanitary and in good operating condition. All kitchen, food preparation and storage areas were clean. Snack menus are posted at least one week in advance where an authorized representative can view them. Drinking water was available both indoors and outdoors. The facility had one or more functioning carbon monoxide detectors that meet statutory requirements. There were no bodies of water, firearms and/or ammunition on the premises. No poisons were observed during the inspection. Playground equipment was in safe condition, free of sharp, loose or pointed parts.

SUPERVISOR'S NAME: Susie Fanning	TELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Theresa Marquez	TELEPHONE: (559) 341-7123
LICENSING EVALUATOR SIGNATURE:	DATE: 09/21/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2021

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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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: 09/21/2021

NARRATIVE

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The surface of the outdoor activity space was maintained in a safe condition and was free of hazards. Areas around high climbing equipment, swings and slides have cushioning material to absorb falls.

A sample of children's files were reviewed and contained contact information for authorized representative and/or relatives or others who can assume responsibility for the child and medical assessment. LPA also reviewed a sample of staff files and observed they contained health screening, immunization records for influenza, pertussis, and measles and current documentation of completed Mandated Reporter Training. At least one person trained in CPR and pediatric First Aid is present when children are at the facility or at off-site activities.

Prior to working or volunteering in a licensed child care facility, all individuals subject to a criminal record review have received a criminal record clearance or exemption.

Incidental Medical Services (IMS) are not currently being provided. Licensee is aware that an IMS plan is required to be submitted to the Licensing Office if they provide any of these services. Information regarding Amercians 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://ww.ada.gov/chilqanda.htm.

LPA and Licensee discussed the Community Care Licensing website www.ccld.ca.gov which will provide 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 Title 22, Division 12, Chapter 1 of the California Code of Regulations no deficiencies were observed today.

SUPERVISOR'S NAME: Susie Fanning	TELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Theresa Marquez	TELEPHONE: (559) 341-7123
LICENSING EVALUATOR SIGNATURE:	DATE: 09/21/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2021

LIC809 (FAS) - (06/04)

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