103810090-11-7-2019-04-CC-CBRN-BHPQWF-20191107113152

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 103810090
Report Date: 11/07/2019
Date Signed: 11/07/2019 11:32:04 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:	CSN EARLY EDUCATION CENTER		FACILITY NUMBER:	103810090
ADMINISTRATOR:	AVILA, CHRISTINA		FACILITY TYPE:	830
ADDRESS:	1318 K STREET		TELEPHONE:	(559) 399-3061
CITY:	SANGER	STATE: CA	ZIP CODE:	93657
CAPACITY:	12	CENSUS: 0	DATE:	11/07/2019
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	07:45 AM
MET WITH:	Christina Avila		TIME COMPLETED:	12:00 PM

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 Program Director, Christina Avila. The licensee is requesting an Infant license with a capacity of 12 infants, including up to 9 crib babies. This program will operate year round, daily from 7:00 AM to 6:00 PM, Monday through Friday. Licensee will provide formula, breakfast, lunch and snack. The meals are prepared on site. There is a sink with hot water inside kitchen for food preparation. Ill children and staff will utilize the staff bathroom located in the classroom. Ill children will be isolated in supervisor office. Room measurements taken and reviewed with Christina Avila. There is one infant classroom. The infant square footage is 602 which will accommodate the requested capacity of 12 infants. Crib area available and can accommodate 9 cribs. Refrigerator available for infant formula, bottles, and infant food. There is a changing table with cushioning and 3" sides within arm’s length from sink. This sink is not to be used for food preparation. 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: 11/07/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2019

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: CSN EARLY EDUCATION CENTER	FACILITY NUMBER: 103810090
	VISIT DATE: 11/07/2019

NARRATIVE

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Adequate storage space available for children's belongings. Outdoor storage is available for toys and equipment. Toys and equipment are age appropriate. Outdoor measurements taken on this date total 589 square feet which will NOT accommodate the requested capacity of 12 infants. During today's visit, director provided a waiver request for the infant outside play area. An outside play schedule was provided during today's visit. Adequate shade is available in the outdoor activity area. There is no climbing equipment in the infant outside play yard.

The fire clearance has been received and approved for the twelve infants.

A working carbon monoxide is installed. The infant program does not provide toilet training.

Pending a final file review and completion, a recommendation will be made to license the above facility for a capacity of 12 infants.

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SUPERVISOR'S NAME: Michael Duarte	TELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Cynthia Brannon	TELEPHONE: (559) 341-5155
LICENSING EVALUATOR SIGNATURE:	DATE: 11/07/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2019

LIC809 (FAS) - (06/04)

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