150405029-11-14-2022-57-CC-PESA-CL6SZU-20221114131944

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 150405029
Report Date: 11/14/2022
Date Signed: 11/14/2022 01:19:51 PM

Document Has Been Signed on 11/14/2022 01:19 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME:	NORTH KERN CHRISTIAN PRE-SCHOOL AND DAYCARE		FACILITY NUMBER:	150405029
ADMINISTRATOR:	VALERIE ALEMAN		FACILITY TYPE:	850
ADDRESS:	710 PETERS STREET		TELEPHONE:	(661) 758-5997
CITY:	WASCO	STATE: CA	ZIP CODE:	93280
CAPACITY:	45	CENSUS: 14	DATE:	11/14/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Valerie Aleman, Director		TIME COMPLETED:	01:30 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	On 11/14/2022, Licensing Program Analyst (LPA) Pete Espinoza, conducted an unannounced Annual Inspection. LPA met with Valerie Aleman, Director. LPA toured facility, indoors and outdoors. Hours of operation are Monday – Friday, 7:15 AM. - 5:15 PM. All children are under supervision, including visual supervision, of a teacher at all times. There is a ratio of one teacher supervising no more than 12 children in attendance. There is no swimming pool or other bodies of water on the premises. There are no firearms or ammunition allowed or stored on the premises. Disinfectants, cleaning solutions, medication, and other hazardous items are made inaccessible. No poisons were observed during the inspection. Furniture and equipment are in good condition, free of sharp, loose, or pointed parts. All toilets and handwashing facilities are in safe and sanitary operating condition. All floors are clean and safe. The facility is free of flies, insects and rodents. Facility has one or more functioning carbon monoxide detectors that meet statutory requirements. Meals are prepared by Wasco Elementary School District and delivered to the classroom. All food is protected against contamination and any contaminated food is discarded immediately. Solid waste storage containers have tight-fitting covers and are in good repair. Uncontaminated drinking water is available both indoors and outdoors. Menus are posted at least one week in advance where an authorized representative can view them. Playground equipment is in safe condition, free of sharp, loose, or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. Areas around high climbing equipment, swings, and slides have cushioning material in the form of wood chips to absorb falls. (Continued on LIC 809-C)

SUPERVISOR'S NAME: Duane Matsubara	TELEPHONE: (559) 650-7855
LICENSING EVALUATOR NAME: Peter Espinoza	TELEPHONE: (661) 644-8231
LICENSING EVALUATOR SIGNATURE:	DATE: 11/14/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/14/2022

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
FRESNO SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: NORTH KERN CHRISTIAN PRE-SCHOOL AND DAYCARE	FACILITY NUMBER: 150405029
	VISIT DATE: 11/14/2022

NARRATIVE

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Facility representative was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Capacity and limitations as specified on the license are being maintained. At least one person trained in Pediatric CPR and First Aid is present when children are at the facility or at offsite activities. The person who signs the child in/out of the facility uses their full legal signature and records the time of day. LPA reviewed a sample of children’s files which contained contact information for authorized representatives or others who can assume responsibility if the authorized representative cannot be reached. A review of Children's files indicated there is no proof of completed Admission Agreement for any child enrolled in preschool. LPA observed that all children’s files contained a medical assessment. LPA reviewed staff files and observed files were complete with health screening, immunization records for influenza, pertussis, and measles, and current documentation of completed mandated reporter training.

This facility does not provide Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. 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

LPA and Teacher Director discussed the Community Care Licensing (CCL) website (www.ccld.ca.gov) which provides access to Provider Information Notices (PINs), Quarterly Updates, COVID-19 Information and Resources, Mandated Reporter Training, Safe Sleep in Child Care, Lead Poisoning Facts, Forms and Regulations.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following deficiency is being cited: (see next page, 809 D) Licensee was provided a copy of appeal rights. Exit interview conducted and report was reviewed with the Director. A notice of site visit was given and must remain posted for 30 days.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

SUPERVISOR'S NAME: Duane Matsubara	TELEPHONE: (559) 650-7855
LICENSING EVALUATOR NAME: Peter Espinoza	TELEPHONE: (661) 644-8231
LICENSING EVALUATOR SIGNATURE:	DATE: 11/14/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/14/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 11/14/2022 01:19 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: NORTH KERN CHRISTIAN PRE-SCHOOL AND DAYCARE	FACILITY NUMBER: 150405029
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 11/14/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101221(b)(6)

Child's Records

(b) Each record shall contain information including, but not limited to, the following: (6) A signed copy of the admission agreement specified in Section 101219. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited, which poses a potential health, safety or personal rights risk to persons in care. A review of Children's files indicated there is no proof of completed Admission Agreement for any child enrolled in preschool
	POC Due Date: 12/05/2022
	Plan of Correction
1 2 3 4	Director will send to Fresno Regional Office, a draft of Admission Agreement for review and approval. Upon approval, Director will complete Admission Agreement for each child enrolled in Preschool.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Duane Matsubara	TELEPHONE: (559) 650-7855
LICENSING EVALUATOR NAME: Peter Espinoza	TELEPHONE: (661) 644-8231
LICENSING EVALUATOR SIGNATURE:	DATE: 11/14/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/14/2022

LIC809 (FAS) - (06/04)

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