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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103808434
Report Date: 05/06/2019
Date Signed: 05/09/2019 10:49:53 AM

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:FUSD-CENTENIALFACILITY NUMBER:
103808434
ADMINISTRATOR:MADDEN, KATHERINEFACILITY TYPE:
850
ADDRESS:3830 E. SAGINAWTELEPHONE:
(559) 457-3683
CITY:FRESNOSTATE: CAZIP CODE:
93726
CAPACITY:24CENSUS: 16DATE:
05/06/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:50 PM
MET WITH:Head Teacher Rita MaciasTIME COMPLETED:
03:10 PM
NARRATIVE
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An unannounced Annual/Random inspection was conducted by Licensing Program Analyst Patricia Musso today. This preschool center is located on north side of Centenial School grounds and uses classroom K-2. A tour of this facility was conducted inside and outside. A complete file review was made prior to today's visit. Staff and children were spoken to during inspection. The following areas are in compliance:
There are no bodies of water, and Rita said there are no fire arms, weapons, ammunition, or poisons stored on the premises. Disinfectants, cleaning compounds, and other hazardous items are inaccessible to children. Furniture and equipment are sufficient, age appropriate and in good repair. The playground equipment and outdoor activity space is maintained and in good condition. In a discussion with Rita, LPA confirmed that if any play equipment needs a repair, it is not to be used until repaired to prevent a deficiency. Areas around/under climbing and play structures has sufficient cushion to absorb falls. Rita was reminded to have the bark raked out from under the play structure and to the landing areas of the play structure. Children's toilets, hand washing facilities are safe and sanitary. Rooms are safe and clean. AM & PM snacks are provided for the children at this facility. Trash cans with solid waste have tight fitting lids.
Sanitary drinking water is available inside and out. Children use a water faucet for the inside and an Igloo with disposable cups that are in a dispenser to keep sanitized and within regulations.
The facility is in compliance with conditions and limitations specified on the license. Teacher/child ratios are maintained and adequate supervision is being provided during this visit. No excluded individuals are present. Staff subject to a criminal record clearance or exemption are associated to the facility.
First aid/CPR reviewed and in compliance. Health screening reviewed for some teachers.
Sign in/sign out sheets maintained in compliance. Emergency information/medical assessment reviewed for some children.
This facility operates a two half day program; Mon-Fri, 8:00-11:00 am and 12:00- 3:00 pm
SUPERVISOR'S NAME: Duane MatsubaraTELEPHONE: (559)650-7855
LICENSING EVALUATOR NAME: Patricia MussoTELEPHONE: (559) 341-5422
LICENSING EVALUATOR SIGNATURE:

DATE: 05/06/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/06/2019
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 3
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: FUSD-CENTENIAL
FACILITY NUMBER: 103808434
VISIT DATE: 05/06/2019
NARRATIVE
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Incidental Medical Services was discussed. Rita said that the school nurse handles the IMS. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.
LPA reminded Rita that all updated information for Community Care Licensing can be obtained through the CCL website; www.ccld.ca.gov The website includes the new PIN (Provider Information Notification) and information for providers including the Quarterly Update that informs licensees of new legislation and regulations. Please follow these steps go to http://www.cdss.ca.gov/, click on “information and resources” click “Community Care Licensing” Click “quarterly updates” click “Child Care advocates program” and register to PIN.

Rita was only able to find her certificate for the Mandated Reporter Training. LPA reminded Rita that the Mandated Reporter Training is required to be completed by each person who assist with the children and needs to be updated every two years.
Rita was unable to find the required immunization/vaccine verifications of pertussis and measles for all who assist with the children.

During the exit interview that was conducted, LPA viewed the Notice of Site Visit Form that was left today being posted and left instructions that it is to be posted for 30 days

Licensee to send updated LIC500 and LIC610 to CCL at times of any changes.

Rita confirmed that there are no Registered Sex Offenders living in the facility and/or using the facility address for their mailing address.

Per Chapter 3, Division 12, Title 22 of the California Code of Regulations, the following deficiencies are cited on LIC809D (see next page):

SUPERVISOR'S NAME: Duane MatsubaraTELEPHONE: (559)650-7855
LICENSING EVALUATOR NAME: Patricia MussoTELEPHONE: (559) 341-5422
LICENSING EVALUATOR SIGNATURE:

DATE: 05/06/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/06/2019
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: FUSD-CENTENIAL
FACILITY NUMBER: 103808434
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/06/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/20/2019
Section Cited
CCR
1596.7995(c)
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Health & Safety Code -1596.7995(c) - Employees failed to have appropriate complete records for immunizations (Influenza, Pertussis & Measles) by 9/1/16.
This requirement was not met as
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Rita believes that all staff have the required immunization/vaccines but could not find today in staff files. Rita will contact headquarters to see if immunization records are there. If teachers do not have immunization records to
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evidenced by no proof of the SB792 required for immunization/vaccines while reviewing staff files. This poses a potential risk to the health, safety, or personal rights of children in care.
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fulfill the requirement, staff will need to get the required Pertussis, measles and flu per SB792. Rita will contact/call LPA with the information of the staff having or not having the immunizations/vaccines by 5/20/19
Type B
05/20/2019
Section Cited
HSC
1596.8662
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H&S Code 1596.8662 -Child Abuse Mandated Reporter Training: Beginning January 1, 2018: Requires all licensed providers and employees to complete the training as specified on their mandated reporter duties and to renew the training every two years. This regulation was not met as observed during file review
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Rita make sure all staff takes the required Mandated Reporter Training. Rita will send in copies of the mandated reporter training certificate to LPA by or before 5/2019. Copy of website address
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the licensee does not have proof that staff have taken required mandated reporter training. This is a potential risk to the health, safety or personal rights of children in care.
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was given on this report.
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: Duane MatsubaraTELEPHONE: (559)650-7855
LICENSING EVALUATOR NAME: Patricia MussoTELEPHONE: (559) 341-5422
LICENSING EVALUATOR SIGNATURE:

DATE: 05/06/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/06/2019
LIC809 (FAS) - (06/04)
Page: 3 of 3