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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103808435
Report Date: 12/05/2019
Date Signed: 12/05/2019 01:48:16 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:FUSD-NORSEMANFACILITY NUMBER:
103808435
ADMINISTRATOR:MADDEN, KATHERINEFACILITY TYPE:
850
ADDRESS:4636 E. WELDONTELEPHONE:
(559) 457-3683
CITY:FRESNOSTATE: CAZIP CODE:
93703
CAPACITY:22CENSUS: 0DATE:
12/05/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Cher HangTIME COMPLETED:
02:10 PM
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An annual random inspection was conducted by Licensing Program Analysts (LPAs) Ginny Badhesha and Kathy Pacheco. LPAs met with Lead Teacher Cher Hang and toured the facility inside and outside, as shown on the facility sketch. Present today was the lead teacher and two assistants. No children were present because the lead teacher is holding parent conferences today. Preschool classroom is located in a portable on the Norseman Elementary School grounds. This facility operates a morning and afternoon class during the traditional school year. Days and hours are Monday through Friday from 8:15am to 11:15am and 11:45am to 2:45pm. No bodies of water present. Firearms/weapons are not allowed or stored on premises. All children present receive direct visual supervision at all times. Facility is operating within the approved licensed capacity at this inspection. All disinfectants, cleaning solutions, toxic, poisonous items, and medications are inaccessible to children. All toilets and hand washing areas are in safe and sanitary condition. All floors are clean and safe. Furniture and equipment are in good condition; free of sharp, loose or pointed parts. There is adequate heating, lighting and ventilation. Snack is provided. Breakfast and lunch is prepped and served in the school cafeteria and children are escorted by parents to the cafeteria if they choose to. Solid waste storage vessels, including moveable bins, have tight fitting covers on, and are in good repair. Uncontaminated drinking water is available both indoors and out. Menus are posted at least one week in advance where an authorized representative can view them. Menus shall be dated and kept on file for 30 days and be available for review upon request. Facility has at least one functioning carbon monoxide detector that meets statutory requirements. Playground equipment is in good condition, free of sharp, loose, or pointed parts. Outdoor activity space surface is maintained in safe condition and free of hazards. Areas under/around high climbing equipment and slides have sufficient bark cushioning material to absorb falls.

(Continued on 809-C)
SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Gagandip BadheshaTELEPHONE: (559) 575-6900
LICENSING EVALUATOR SIGNATURE:

DATE: 12/05/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2019
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: FUSD-NORSEMAN
FACILITY NUMBER: 103808435
VISIT DATE: 12/05/2019
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Licensee does not exceed the conditions, limitations, and capacity specified on the license. Before working or volunteering in a licensed child care facility, all individuals subject to a criminal record review have a clearance or exemption through Fresno Unified School District. There are no excluded individuals present at this center. Licensee is aware that upon notice from the Department, any excluded individual must be immediately removed from the center. Staff records contain appropriate documentation. Children files were included all required documents. At least one person trained in Pediatric CPR/First and is present when children are at the facility or at off site activities. The responsible person who signs the child in/out uses their full legal signature and records the time of day.

Incidental Medical Services (IMS) are not currently being provided. IMS policy was discussed. Licensee is aware that an IMS plan is required to be submitted to the Licensing office if they provide any of these services.

Licensee was provided with Lead Poisoning Facts brochure.



Per California Code of Regulations, Title 22, Division 12, Chapter 1, in the areas evaluated no deficiency was cited during today's visit.

Exit interview conducted with Lead Teacher Cher Hang and a copy of this report was provided and discussed.

A Notice of Site Visit Form (LIC 9213) was posted on parent's board and must remain posted for 30 days.

LPA and Licensee discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINS), Quarterly Updates, Mandated Reporter Training, Safe Sleep in Child Care, Lead Poisoning Facts, Forms and Regulations.
SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Gagandip BadheshaTELEPHONE: (559) 575-6900
LICENSING EVALUATOR SIGNATURE:

DATE: 12/05/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2019
LIC809 (FAS) - (06/04)
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