103810134-9-28-2021-04-CC-JMOA-C7B2UN-20210928174237

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 103810134
Report Date: 09/09/2021
Date Signed: 09/28/2021 05:42:41 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 PRESCHOOL		FACILITY NUMBER:	103810134
ADMINISTRATOR:	BARKOWSKY, TIFFANY		FACILITY TYPE:	850
ADDRESS:	1568 WILLIAMS ST		TELEPHONE:	(559) 897-6989
CITY:	KINGSBURG	STATE: CA	ZIP CODE:	93631
CAPACITY:	48	CENSUS: 15	DATE:	09/09/2021
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	02:38 PM
MET WITH:	Tiffany Barkiwsky		TIME COMPLETED:	02:39 PM

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On 09/09/2021, Licensing Program Analyst (LPA) Juvenal Moctezuma conducted an unannounced Case Management 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 is removing classroom A and going back to just being licensed on classroom C. 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 classroom C and outside in the play area. Ill Children will be isolated in the Site supervisors office inside classroom C and utilize the staff bathroom there. Classroom C was observed to be clean and free of toxins. The cleaning items will be stored in a high cabinet which will be locked and inaccessible to children. 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 Tiffany. The total inside preschool area measured to an approximate 944 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 2 toilets and 2 sinks/hand washing fixtures inside Classroom C which will accommodate the requested capacity. There is a bathroom out in the play area that will be shared with another licensed preschool facility and early intervention program. Tiffany stated that she will submit a waiver request and understands that children will not be commingled. There is a 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 Duarte	TELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Juvenal Moctezuma	TELEPHONE: (559) 580-0275
LICENSING EVALUATOR SIGNATURE:	DATE: 09/09/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2021

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: WASHINGTON PRESCHOOL	FACILITY NUMBER: 103810134
	VISIT DATE: 09/09/2021

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The Garden Area is behind the children's classroom and is gated. There are umbrellas that provide shade and the AC Units are barricaded. 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. 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 from Kingsburg Fire Department was received and granted for 27 preschool children on 9/7/2021.

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

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

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: 09/09/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2021

LIC809 (FAS) - (06/04)

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