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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103810134
Report Date: 09/03/2020
Date Signed: 09/08/2020 04:30:54 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:WASHINGTON PRESCHOOLFACILITY NUMBER:
103810134
ADMINISTRATOR:BARKOWSKY, TIFFANYFACILITY TYPE:
850
ADDRESS:1568 WILLIAMS STTELEPHONE:
(559) 897-6989
CITY:KINGSBURGSTATE: CAZIP CODE:
93631
CAPACITY:27CENSUS: 0DATE:
09/03/2020
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
04:00 PM
MET WITH:Tiffany BarkowskyTIME COMPLETED:
05:20 PM
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On 09/03/2020, Licensing Program Analyst (LPA) Juvenal Moctezuma conducted an announced prelicensing inspection and met with Site Supervisor, Tiffany Barkowsky. LPA explained the reason of the inspection and a tour of the center was conducted both inside and outside. Licensee was previously licensed on the premises of Washington Elementary School at 1501 Ellis in Kingsburg CA. They have now relocated to the other side of the campus which has a new address but its still in the same premises as Washington Elementary School. The center is located on 1568 Williams St In Kingsburg, CA. The licensee is requesting a capacity of 27 Preschool children. This program will operate on a traditional school year from 08:00 AM to 11:15 AM & from 11:45 AM to 3:00 PM Monday through Friday. This program will operate in classrooms labeled #C. 2 snacks will be provided since the program is only half day. Staff will utilize the staff bathroom located inside the classroom. Ill Children will be isolated in the Site supervisors office and utilize the staff bathroom. The classroom was observed to be clean and free of toxins. The cleaning items will be stored in a high cabinet inside the children's bathroom which are inaccessible. LPA observed that the furniture and equipment appeared to be safe and in good condition. A working carbon monoxide needs to be installed.

Room measurements were taken and reviewed with Tiffany. The total inside preschool area measured to an approximate 945 square feet which will accommodate the requested capacity. There is adequate storage space available for children's belongings. Toys and equipment are age appropriate. There is a total of 3 toilets and 3 sinks/hand washing fixtures which will accommodate the requested capacity. There is drinking fountain inside the classroom. Licensee will utilize a water igloo and disposable cups for outside drinking water.

The approximate outside square footage for the preschool area is 21,418 which will accommodate the requested capacity of 27 Preschool Children. Licensee will share the playground and garden area with Washing preschool- Educare & Washington Early Intervention preschool program.

Report Continued Onto LIC 809-C

SUPERVISOR'S NAME: Michael DuarteTELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Juvenal MoctezumaTELEPHONE: (559) 580-0275
LICENSING EVALUATOR SIGNATURE:

DATE: 09/03/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2020
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 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: WASHINGTON PRESCHOOL
FACILITY NUMBER: 103810134
VISIT DATE: 09/03/2020
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The Garden Area is behind the children's classroom and is gated. The playground is towards the front of the classroom. There are age appropriate play structures that have the age appropriate sticker and there are plenty of wood chips in the fall zone areas. There is a shade structure to provide shade. Out in the play yard, there is an extra children's bathroom so they don't need to come inside the classroom. The bathroom will also be shared with the other 2 classrooms. There is a grass area with trees that will provide shade. There are sheds to store children's toys and belongings which will remain closed and locked at all items. LPA reminded licensee to provide adequate supervision at all times.

A fire clearance for 27 children was received and granted by the Kingsburg Fire Department on 04/02/2020.

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 09/17/2020.

Classroom

  • Anchor Big cabinets and wooden furniture to prevent from tipping over
  • Waiver request to share the playground/garden area & Outside bathroom.
  • Water dispenser & Igloo with disposable cups
  • Carbon Monoxide
  • Get 2 Window Screens
  • Trash Lids
Play yard
  • Shave all the threads bolts to a recommended size of 3/4 around the whole fence area.
  • Make AC Units inaccessible to children out in the garden area.
  • Get Shade structure or pop up shade structure in the garden area (will need to be anchored).
  • Cover the water spigots and water pipes all around the playground to make them inaccessible to children.
  • Clean toys since they have spider webs and are dirty before children arrive at center


Report Continued Onto LIC 809-C
SUPERVISOR'S NAME: Michael DuarteTELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Juvenal MoctezumaTELEPHONE: (559) 580-0275
LICENSING EVALUATOR SIGNATURE:

DATE: 09/03/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2020
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: WASHINGTON PRESCHOOL
FACILITY NUMBER: 103810134
VISIT DATE: 09/03/2020
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  • Paint red tables since rust and metal is showing
  • Get a tarp for Sand Box
  • Get cover for the planter box or make it inaccessible to children
  • Close off the space between the east side of the shed and the chain link fence.
  • Fill in the ramp with wood chips to prevent tripping hazards.
  • Make sure bushes in the round planters are trimmed or cut low to not impede visual observation at all times.


Pending a final file review and completion of above items, a recommendation will be made to license the above facility for a capacity of 27 preschool 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

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 DuarteTELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Juvenal MoctezumaTELEPHONE: (559) 580-0275
LICENSING EVALUATOR SIGNATURE:

DATE: 09/03/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2020
LIC809 (FAS) - (06/04)
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