150408907-9-2-2022-57-CC-KPAO-CHVQCC-20220902120255

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 150408907
Report Date: 09/02/2022
Date Signed: 09/02/2022 12:03:07 PM

Document Has Been Signed on 09/02/2022 12:03 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:	GREENFIELD COUNTRY PRESCHOOL		FACILITY NUMBER:	150408907
ADMINISTRATOR:	HASKINS/HALL		FACILITY TYPE:	830
ADDRESS:	7690 S. UNION		TELEPHONE:	(661) 834-8184
CITY:	BAKERSFIELD	STATE: CA	ZIP CODE:	93307
CAPACITY:	24	CENSUS: 17	DATE:	09/02/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Traci Myers		TIME COMPLETED:	12:30 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 9/2/22, Licensing Program Analyst (LPA) Kathy Pacheco and LPA Diane Mercado conducted an unannounced annual inspection at the facility. LPA met with Traci Myers. A tour of the facility was conducted indoors and outdoors. There were no bodies of water, firearms and/or ammunition on the premises. No poisons were observed during the inspection. Furniture and equipment were in good condition, free of sharp, loose or pointed parts. Playground equipment was in safe condition, free of sharp, loose or pointed parts. The surface of the outdoor activity space was maintained in a safe condition and was free of hazards. The facility has sufficient age appropriate furniture, and equipment including cribs, cots or mats, changing tables and feeding chairs. There is indoor and outdoor activity space for infants that is physically separate. Each crib, mat or cot is occupied by only one infant at time and cribs are kept free from all loose articles including blankets and pillows and there are no objects hanging above or attached to the crib. Infants are not swaddled while in care. Staff physically checks on sleeping infants every fifteen minutes and documents any signs of distress which includes but is not limited to flushed skin color, increase in body temperature, restlessness and labored breathing. Documentation for infants up to 12 months includes sleeping position if it is other than on their back. Individual Infant Sleeping Plan is completed and in file for each infant up to 12 months of age. Infants up to 12 months of age are placed on their backs for sleeping. Staff-infant ratio requirements are being met while infants are sleeping. Floors in the facility were clean and safe. All kitchen, food preparation and storage areas were clean and free of litter/rubbish. The facility was free of flies, insects, and rodents/vermin. All food was protected against contamination and any contaminated food is discarded immediately. Solid waste storage containers had tight-fitting covers and were in good repair. Menus are posted at least one week in advance where an authorized representative can view them. Drinking water was available both indoors and outdoors. The facility had one or more functioning carbon monoxide detectors that met statutory requirements. (continued)

SUPERVISOR'S NAME: Luisa Gavoutian	TELEPHONE: (559) 650-7879
LICENSING EVALUATOR NAME: Kathy Pacheco	TELEPHONE: (559) 341-5116
LICENSING EVALUATOR SIGNATURE:	DATE: 09/02/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2022

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: GREENFIELD COUNTRY PRESCHOOL	FACILITY NUMBER: 150408907
	VISIT DATE: 09/02/2022

NARRATIVE

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Capacity and limitations as specified on the license are being maintained. The name of the child care center Director or fully-qualified teacher(s) designated to act in the Director's absence has been reported to the Department. The facility maintains a ratio of one teacher supervising no more than 4 children in care. All children are under supervision, including visual supervision, of a teacher at all times. The person who signs the child in/out of the facility shall use their full legal signature and record the time of day. A sample of children's files were reviewed and contained contact information for authorized representative and/or relatives or others who can assume responsibility for the child, medical assessment, individual feeding plan, and Infant Needs and Services Plan. Staff files reviewed and documentation observed for health screening, immunization records for pertussis, measles, and influenza and/or declaration declining the flu shot. Verification of current Mandated Reporter Training for all staff was not available. At least one person trained in CPR and pediatric First Aid is present when children are at the facility or at off-site activities.

LPA discussed the safe sleep regulations with Licensee and discussed the Child Care Licensing Safe Sleep webpage at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed Licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at: https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing 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

LPA discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINs), Quarterly Updates, COVID-19 Information and Resources, Mandated Reporter Training, Lead Poisoning Facts, Forms and Regulations.
(continued)

SUPERVISOR'S NAME: Luisa Gavoutian	TELEPHONE: (559) 650-7879
LICENSING EVALUATOR NAME: Kathy Pacheco	TELEPHONE: (559) 341-5116
LICENSING EVALUATOR SIGNATURE:	DATE: 09/02/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2022

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: GREENFIELD COUNTRY PRESCHOOL	FACILITY NUMBER: 150408907
	VISIT DATE: 09/02/2022

NARRATIVE

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Facility 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.

Operating hours are Monday through Friday 6:30 AM to 6:00 PM.

Per Title 22, Division 12, Chapter 1 of the California Code of Regulations no deficiencies were observed today.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with Director Traci Myers.

SUPERVISOR'S NAME: Luisa Gavoutian	TELEPHONE: (559) 650-7879
LICENSING EVALUATOR NAME: Kathy Pacheco	TELEPHONE: (559) 341-5116
LICENSING EVALUATOR SIGNATURE:	DATE: 09/02/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2022

LIC809 (FAS) - (06/04)

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