103810105-8-24-2020-04-CC-JMOA-BSSTH3-20200824144405

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 103810105
Report Date: 08/22/2020
Date Signed: 08/24/2020 02:44:10 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:	JACK & JILL'S EARLY CHILD DEVELOPMENT CENTER, INC		FACILITY NUMBER:	103810105
ADMINISTRATOR:	GRAVES, EARLINE EVETTE		FACILITY TYPE:	840
ADDRESS:	969 S WILLOW AVE		TELEPHONE:	(559) 255-8817
CITY:	FRESNO	STATE: CA	ZIP CODE:	93727
CAPACITY:	55	CENSUS: 0	DATE:	08/22/2020
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Earline Graves		TIME COMPLETED:	11:30 AM

NARRATIVE

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On 08/22/2020, Licensing Program Analyst (LPA) Juvenal Moctezuma conducted an announced prelicensing inspection and met with Licensee, Earline Graves & Previous Licensee Shirley Harris. LPA explained the reason of the inspection and a tour of the center was conducted both inside and outside. The center is located on 969 S. Willow Ave in Fresno, CA. Shirley did a Change of Ownership to Earline who is requesting a capacity of 55 School Age children. This program will operate year round from 5:45 AM to 6:15 PM Monday through Friday. This program will operate in one classroom. Breakfast, Lunch, & PM snack will be provided and prepared on site. There is a sink with hot water inside kitchen. Staff will utilize the bathroom that's located out in the playground next to the lawn area. Ill children will be isolated in the Directors office and utilize the staff bathroom. The classroom was observed to be clean and free of toxins. LPA observed that the Furniture and equipment appeared to be safe and in good condition. A working carbon monoxide is installed.

Room measurements were taken and reviewed with Earline & Shirley. The total inside preschool area measured to an approximate 1924 square feet which will accommodate the requested school age capacity. There is adequate storage space available for children's belongings. Toys and equipment are age appropriate. There is a total of 4 toilets and 4 sinks/hand washing fixtures which will accommodate the requested capacity. Earline stated that the facility will utilize igloos with disposable cups for children to drink water both indoors and outdoors.

The approximate outside square footage is 4,085 which will accommodate the requested capacity. Licensee has submitted a waiver request and is pending approval to also utilize the preschool playground. Separation will be done through separate recess times. The preschool playground has a shade structure and there is a mature tree to provide additional shade in the school age play area. There is an outside storage area for children's toys and equipment. The Licensee is using sand for cushioning under the outdoor climbing structure. The play structure has an age sticker that states its age appropriate for preschool children.

Report Continued Onto LIC 809-C

SUPERVISOR'S NAME: Michael Duarte	TELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Juvenal Moctezuma	TELEPHONE: (559) 580-0275
LICENSING EVALUATOR SIGNATURE:	DATE: 08/22/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2020

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: JACK & JILL'S EARLY CHILD DEVELOPMENT CENTER, INC	FACILITY NUMBER: 103810105
	VISIT DATE: 08/22/2020

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A fire clearance for 141 children was received and granted by the Fresno City Fire Department on 08/11/2020.

This facility plans to provide Incidental Medical Services – IMS. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. A 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 09/07/2020.

Classroom

Get window screens for all windows that are missing them
Anchor cubbies to prevent from tipping over.
Licensee will get more cubby space to match the requested capacity.
Get copies of control of property

Play yard

Shave all the threads bolts to a recommended size of 3/4 around the fence.
Repaint School Age Playground since metal & rust is showing
Submit waiver request to use preschool playground

Pending a final file review and completion of above items, a recommendation will be made to license the above facility for a capacity of 55 School age children.

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)
* Activity Schedule
* Lead Poisoning brochure

SUPERVISOR'S NAME: Michael Duarte	TELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Juvenal Moctezuma	TELEPHONE: (559) 580-0275
LICENSING EVALUATOR SIGNATURE:	DATE: 08/22/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2020

LIC809 (FAS) - (06/04)

Page: 2 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: JACK & JILL'S EARLY CHILD DEVELOPMENT CENTER, INC	FACILITY NUMBER: 103810105
	VISIT DATE: 08/22/2020

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 26 27 28 29 30 31 32	No deficiencies cited during today's visit. A COPY OF THIS REPORT IS TO REMAIN IN THE FACILITY FOR PUBLIC REVIEW. THIS REPORT SHALL BE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. To order forms, etc. visit our website at www.ccld.ca.gov

SUPERVISOR'S NAME: Michael Duarte	TELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Juvenal Moctezuma	TELEPHONE: (559) 580-0275
LICENSING EVALUATOR SIGNATURE:	DATE: 08/24/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2020

LIC809 (FAS) - (06/04)

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