103810039-1-31-2020-04-CC-TMAZ-BLCQLX-20200131111640

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 103810039
Report Date: 01/31/2020
Date Signed: 01/31/2020 11:16:55 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:	COPPER ACADEMY PRIVATE PRESCHOOL		FACILITY NUMBER:	103810039
ADMINISTRATOR:	GONG, ALEXA		FACILITY TYPE:	850
ADDRESS:	2042 E COPPER AVE STE 107		TELEPHONE:	(559) 477-0503
CITY:	FRESNO	STATE: CA	ZIP CODE:	93730
CAPACITY:	16	CENSUS: 13	DATE:	01/31/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Sandy Gong & Alexa Gong		TIME COMPLETED:	11:30 AM

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 January 31, 2020, Licensing Program Analyst (LPA) Theresa Marquez conducted an unannounced Annual inspection and met with Director Alexa Gong. Also present, was Director Sandy Gong. 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. This is an AM/PM half day program which operates on a traditional school year schedule. The morning session is 8:00 AM to 11:00 AM and the afternoon session is 11:45 AM to 2:45 PM, with an option for lunch session 11:00 AM to 11:30 AM, Monday through Friday. 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 does not provide meals, only an AM and PM snack. 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. Toilets and hand washing facilities are in safe and sanitary operating conditions. 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, 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: 01/31/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2020

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: COPPER ACADEMY PRIVATE PRESCHOOL	FACILITY NUMBER: 103810039
	VISIT DATE: 01/31/2020

NARRATIVE

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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 California Criminal Record clearance 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.
This facility utilizes an electronic sign-in/sign-out system. Child's admission agreement is available for review.

This facility provides Incidental Medical Services (IMS). No medication was observed today.

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 linkhttps://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: 01/31/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2020

LIC809 (FAS) - (06/04)

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