103810087-10-8-2019-04-CC-CBRN-BGRNL3-20191008103251

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 103810087
Report Date: 10/08/2019
Date Signed: 10/08/2019 10:33:25 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:	TINY TOWN		FACILITY NUMBER:	103810087
ADMINISTRATOR:	DIAZ, RUBEN		FACILITY TYPE:	830
ADDRESS:	601 THIRD ST		TELEPHONE:	(559) 646-2731
CITY:	PARLIER	STATE: CA	ZIP CODE:	93648
CAPACITY:	12	CENSUS: 0	DATE:	10/08/2019
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	08:00 AM
MET WITH:	Rebecca Camargo		TIME COMPLETED:	11:00 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	A prelicensing inspection visit was conducted on this date by Licensing Program Analyst (LPA) Brannon, who met with Site Supervisor/Teacher, Rebecca Camargo. The center is located at Brletic Elementary School. The licensee is Parlier Unified School District. Licensee is requesting a capacity of 8 infants. This program will operate traditional school year unless needed during summer school to meet the high school parents' needs. This facility will be opened Monday through Friday from 7:30 AM to 4:30 PM. Breakfast, lunch, snack will be provided and prepared by Brletic cafeteria. There is a sink with hot water inside kitchen, classroom to use for food preparation. Ill children and staff will utilize the bathroom located at the school site. Ill children will be isolated in the teacher's office. Room measurements taken and reviewed with Rebecca Camargo. There is one classroom with two additional rooms and one main room that will be used by infants. The total infant square footage is 548 which will accommodate the requested capacity of 8 infants. CONTINUED ON FOLLOWING PAGE

SUPERVISOR'S NAME: Michael Duarte	TELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Cynthia Brannon	TELEPHONE: (559) 341-5155
LICENSING EVALUATOR SIGNATURE:	DATE: 10/08/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2019

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: TINY TOWN	FACILITY NUMBER: 103810087
	VISIT DATE: 10/08/2019

NARRATIVE

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The fire clearance has been received and approved for 8 infants.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. 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 following items must be completed prior to issuing a license by 10/22/19:
1. Need shelving by changing table for staff to have access to cleaning solution for before and after each diaper change.
2. Play kitchen needs repairs: blue handle is missing screw and the oven door is missing the handle.
3. The exterior wall between the chain link fence and ramp is damaged and there are exposed pipes. Per licensee, a fence will be installed in this area or repairs and exposed pipes will be made inaccessible.
4. Cat feces was observed in the infants' outside play yard. Licensee shall provide a copy of staff daily inspection log for the outside play area.
CONTINUED ON FOLLOWING PAGE

SUPERVISOR'S NAME: Michael Duarte	TELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Cynthia Brannon	TELEPHONE: (559) 341-5155
LICENSING EVALUATOR SIGNATURE:	DATE: 10/08/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2019

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: TINY TOWN	FACILITY NUMBER: 103810087
	VISIT DATE: 10/08/2019

NARRATIVE

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5. There are long bolts in the fencing. Licensee shall cut the bolts back to 2 to 3 threads.
6. There is peeling brown paint on the exterior wall and the adjacent exterior wall has a chipped/broken wooden panel.
7. The changing pad is not thick enough. Licensee shall provide a changing pad that is at least 1" thick.
8. There is no shade structure or mature tree in the infant outside play yard. Licensee shall provide a shade structure.
9. Licensee does not have a potty chair for older infants.

Pending a final file review and completion of above items, a recommendation will be made to license the above facility for a capacity of 8 infants. LPA will return and conduct an inspection to ensure the above items have been corrected.
Please update LIC 500, LIC 610, LIC 308, Facility Sketch upon licensure.

The following documents should be posted at the facility:
* PUB 269- Child passenger restraint systems poster 101225(f) Transportation
* Pub 393- Notification of Parents Rights 101218.1(c) Admission Procedures
* License 101160(a) License
* Menus 101227(a)(6) Food Services
* LIC 613A- Personal Rights form 101223(b)(2) Personal Rights
* LIC 610- Disaster Plan 101174(a)
* LIC 9148- Earthquake Preparedness Checklist 101174(b)

To order forms, etc. visit our website at www.ccld.ca.gov.

SUPERVISOR'S NAME: Michael Duarte	TELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Cynthia Brannon	TELEPHONE: (559) 341-5155
LICENSING EVALUATOR SIGNATURE:	DATE: 10/08/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2019

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: TINY TOWN	FACILITY NUMBER: 103810087
	VISIT DATE: 10/08/2019

NARRATIVE

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Crib area available and can accommodate 5 cribs. Refrigerator available for infant formula, bottles, infant food. There is a changing table with 5" sides and within arm’s length from sink. This sink is not to be used for food preparation. Adequate storage space available for children's belongings. Licensee has a water dispenser with a disposable cup dispenser and disposable cups to be used as inside drinking water.

Outdoor storage is not available for toys and equipment. Licensee is aware that if a storage shed is installed on the infant play yard, Licensing shall be notified to conduct an inspection and measure the outside play yard. Toys and equipment are age appropriate. Outdoor measurements taken on this date total 2376 square feet which will accommodate the requested capacity of 8 infants. During today's visit, licensee did not install a shade structure. There are no climbing structures.

There is one toilet and one sink/hand washing fixtures in the children's bathrooms which will accommodate the requested capacity of 8 infants. Per Rebecca Camargo, she will not have more than 5 infants being potty trained. Licensee is aware that there shall be a minimum of one hand washing sink to every 15 infants and one potty chair to every 5 infants being toilet trained.

Licensee will be utilizing sippy cups to provide for infants to use for drinking water. Licensee is aware that each cup will be labeled with the infant's name and the current date. Licensee is aware that the sippy cups are to be washed each day after use. Per Rebecca Camargo, this facility has public water services.
CONTINUED ON FOLLOWING PAGE

SUPERVISOR'S NAME: Michael Duarte	TELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Cynthia Brannon	TELEPHONE: (559) 341-5155
LICENSING EVALUATOR SIGNATURE:	DATE: 10/08/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2019

LIC809 (FAS) - (06/04)

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