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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153808652
Report Date: 06/05/2019
Date Signed: 06/05/2019 03:37:15 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:MAOF CESAR CHAVEZ PRESCHOOLFACILITY NUMBER:
153808652
ADMINISTRATOR:GUTIERREZ, MARYFACILITY TYPE:
850
ADDRESS:410 CHANNA DRTELEPHONE:
(661) 721-2032
CITY:DELANOSTATE: CAZIP CODE:
93215
CAPACITY:176CENSUS: 86DATE:
06/05/2019
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Nancy OrtizTIME COMPLETED:
03:45 PM
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Licensing Program Analysts (LPAs) Gloria Reyes and Diana Martinez conducted an unannounced Plan of Correction inspection on 06/05/19. LPAs met with Site Supervisor, Nancy Ortiz. LPAs toured the facility and a census was taken.

On 06/03/19, the following deficiencies were cited and LPAs are here today to evaluate that the following have been completed:

BUILDING AND GROUNDS - Section 101238(g): During the visit, LPAs observed door adjacent to Classroom 1 (Laundry Room) and door adjacent to Classroom 2 (Staff Lounge) has been made inaccessible by a using a lever handle safety lock. The locks were installed on 06/04/19. The plan of correction has been cleared.

HEALTH-RELATED SERVICES – Section 101226(e)(2): During the visit, LPAs observed that prescription medication for C1 and C2 are inaccessible by key lock. Medications labeled contained all required information for children by plan of correction due date. This plan of correction has been cleared.

Per California Code of Regulations, Title 22, Division 12, Chapter 1, no deficiency was cited during today's visit.

An exit interview conducted with Site Supervisor, Nancy Ortiz. A copy of this report was provided and discussed. A Notice of Site Visit Form was posted on parent's board and must remain posted for 30 days.
SUPERVISOR'S NAME: Alice JuarezTELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Gloria ReyesTELEPHONE: (559) 341-4471
LICENSING EVALUATOR SIGNATURE:

DATE: 06/05/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2019
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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