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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103808803
Report Date: 09/17/2019
Date Signed: 09/17/2019 03:35:26 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-MALLOCHFACILITY NUMBER:
103808803
ADMINISTRATOR:MADDEN, KATHERINEFACILITY TYPE:
850
ADDRESS:2251 W. MORRIS AVENUETELEPHONE:
(559) 457-3683
CITY:FRESNOSTATE: CAZIP CODE:
93711
CAPACITY:20CENSUS: 17DATE:
09/17/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Caroline GonzalezTIME COMPLETED:
03:45 PM
NARRATIVE
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On this date, Licensing Program Analyst (LPA) Theresa Marquez conducted an unannounced Annual inspection and met with Substitute Teacher Caroline Gonzalez. Also present were two Teacher Aides. 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. Required CCL forms are posted on parent's board.

This preschool operates between August and June and has an AM & PM session Monday through Friday. The morning session is 8:00 AM to 11:00 AM and the afternoon session is 11:30 AM to 2:30 PM. Children from the morning session may eat breakfast in the cafeteria and the PM children may also eat lunch in the cafeteria. Snacks are provided by parents.

Furniture and equipment are in good condition. All materials and surfaces accessible to children are toxic free. All floors are clean and safe. Snack menus are posted at least one week in advance, where an authorized representative can view them. All toilets, hand washing, and bathing facilities are in safe and sanitary operating conditions.
Medications are stored in the nurse's office and inaccessible to children. No poisons were observed during today’s inspection.

Playground equipment is in good condition, free of sharp, loose, or pointed parts.
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.
SUPERVISOR'S NAME: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Theresa MarquezTELEPHONE: (559) 341-7123
LICENSING EVALUATOR SIGNATURE:

DATE: 09/17/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2019
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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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-MALLOCH
FACILITY NUMBER: 103808803
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/17/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/17/2019
Section Cited

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TEACHER AIDE QUALIFICATIONS & DUTIES - An aide assisting a fully qualified teacher (as specified in Section 101216.1(c)) in the supervision of up to 18 preschool-age children, pursuant to Section 101216.3 shall meet the following requirements: Completion of six post secondary semester or equivalent quarter units
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in early childhood ed. or child develop. This requirement was not met as evidenced by record review. Aide #2 has completed 3 the 6 units of early childhood ed. Aide #3 has not completed early childhood ed. units. This poses a potential risk to the health, safety and personal rights risk to children in care.
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Evidence shall be submitted to the Fresno CCL office by October 17, 2019.

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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: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Theresa MarquezTELEPHONE: (559) 341-7123
LICENSING EVALUATOR SIGNATURE:
DATE: 09/17/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/17/2019
LIC809 (FAS) - (06/04)
Page: 3 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-MALLOCH
FACILITY NUMBER: 103808803
VISIT DATE: 09/17/2019
NARRATIVE
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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.

Staff are employed by Fresno Unified School District and must have background clearances prior to employment. LPA confirmed staff has required immunization.

This facility provides Incidental Medical Services (IMS). All medications are stored in the nurses office. LPA reviewed children’s, personnel, and administrative records. 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

The Program District Manager is to provide the following updated forms to the Fresno CCL office by October 1, 2019: 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, the following deficiencies were observed on the attached LIC809-D. A copy of Licensee’s Appeal Rights was provided to Caroline Gonzalez 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 FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Theresa MarquezTELEPHONE: (559) 341-7123
LICENSING EVALUATOR SIGNATURE:

DATE: 09/17/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2019
LIC809 (FAS) - (06/04)
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