153808652-6-4-2019-04-CC-PESA-BCSUS3-20190603154939

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 153808652
Report Date: 06/03/2019
Date Signed: 06/04/2019 07:21:49 AM

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 PRESCHOOL		FACILITY NUMBER:	153808652
ADMINISTRATOR:	GUTIERREZ, MARY		FACILITY TYPE:	850
ADDRESS:	410 CHANNA DR		TELEPHONE:	(661) 721-2032
CITY:	DELANO	STATE: CA	ZIP CODE:	93215
CAPACITY:	176	CENSUS: 123	DATE:	06/03/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Nancy Ortiz, Site Supervisor		TIME COMPLETED:	04:15 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	LPA's Gloria Reyes & Pete Espinoza made an unannounced Annual/Random inspection. LPA's met with Nancy Ortiz, Site Supervisor. There are no bodies of water and/or firearms allowed or stored on the premises of a child care center. All children are under visual supervision, of a teacher at all times. The Department has inspection authority. There is a ratio of one teacher supervising no more than 12 children in attendance. All materials and surfaces accessible to children are toxic free. All toilets, hand washing, and bathing facilities are in safe and sanitary operating conditions. All floors are clean and safe. Furniture and equipment are in good condition, free of sharp, loose, or pointed parts. All kitchen, food prep, and storage areas are clean, free of litter, rubbish, and rodents/vermin. All food is protected from contamination, and contaminated food is discarded immediately. Solid waste storage vessels, including moveable bins, have tight-fitting covers on, are in good repair. Uncontaminated drinking water is available both indoors and outdoors. All foods/beverages capable of rapid spoiling are stored in covered containers at 45 (F) or less. Menus are posted at least one week in advance, where an authorized representative can view them, are dated and kept on file for 30 days, and are available on request. Facility has one or more functioning carbon monoxide detectors that meet statutory requirements. Playground equipment is in good condition, free of sharp, loose, or pointed parts. Outdoor activity space surface is maintained in a safe condition and is free of hazards. Areas around high climbing equipment, swings, and slides have cushioning material to absorb falls. Before working or volunteering in a licensed child care facility, all individuals subject to a criminal record review have a clearance or exemption and have been associated to the facility. Staff records contain appropriate, documentation of education credits. At least one person trained in CPR and Pediatric first-aid is present when children are at the facility or at off-site activities. The person, who signs the child in/out, is responsible for the child, uses their full legal signature and records the time of day. Child's admission agreement is available for review. See next page:

SUPERVISOR'S NAME: Diana deLeon	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Peter Espinoza	TELEPHONE: 661-644-8231
LICENSING EVALUATOR SIGNATURE:	DATE: 06/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/03/2019

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 4

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: MAOF CESAR CHAVEZ PRESCHOOL	FACILITY NUMBER: 153808652
	VISIT DATE: 06/03/2019

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
26
27
28
29
30
31
32

Facility provided proof required immunizations (Pertussis/Measles) AND certificate of completion for required AB 1207 - California Child Care Workers: Mandated Reporter Training for all staff present at facility at time of visit.

LPA discussed the Community Care Licensing website: Lead Safety, new additions to the website that include the new PIN (Provider Information Notification) and information for providers including the Quarterly Update that informs licensees of new legislation and regulations. Please follow these steps go to http://www.cdss.ca.gov/, click on “information and resources” click “Community Care Licensing” Click “quarterly updates” click “Child Care advocates program” and register to PIN. Operating hours are Mon-Fri 5:00 AM – 5:30 PM

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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 is cited per chapter 1, Title 22, Div. 12 of the CCR. Copy of Appeal Rights left with center representative/licensee.

LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS.

* Any Licensing reports indicating a type A deficiency shall be posted immediately and for the next 30 days and copies provided of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. Health and Safety Section 1596.859(a) shall be cited and a civil penalty of $100.00 for failure to provide copies to parents/guardians of children in care and newly enrolled children, and for failure to maintain written verification of receipt of licensing reports indicating a Type A violation (LIC 9224).

To view e-learning modules: https://ccld.childcarevideos.org/
To order forms, etc. visit our website at www.ccld.ca.gov.

SUPERVISOR'S NAME: Diana deLeon	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Peter Espinoza	TELEPHONE: 661-644-8231
LICENSING EVALUATOR SIGNATURE:	DATE: 06/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/03/2019

LIC809 (FAS) - (06/04)

Page: 2 of 4

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: MAOF CESAR CHAVEZ PRESCHOOL	FACILITY NUMBER: 153808652
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/03/2019

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

CCR

101238(g)

Physical Plant - Buildings and Grounds

(g) Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children shall be stored where inaccessible to children.
	Deficient Practice Statement
1 2 3 4	This requirement is not met as evidenced by observation conducted during today’s inspection. LPA's observed door adjacent to Classroom 1 (Laundry Room) accessible to children and containing a large bucket of laundry detergent. LPA's also observed door adjacent to classroom 2 (Staff lounge) accessible to children and containing a large freezer. This poses an immediate risk to the health, safety or personal rights of children in care.
	POC Due Date: 06/04/2019
	Plan of Correction
1 2 3 4	Licensee will install child protective device on door knob and/or install lock on door. Licensee will send picture to Fresno Regional Office indicating method used to make door inaccessible to children by end of business 06/04/2019.

Type A

Section Cited

CCR

101226(e)(2)

Children Records - Health-Related Services

(2) All prescription and nonprescription medications shall be maintained with the child's name and shall be dated.
	Deficient Practice Statement
1 2 3 4	This requirement is not met as evidenced by observation and records review conducted during today’s inspection. Prescription medication for C-1 & C-2 is NOT identified by name and date. LPA's also observed medication in cabinet that is accessible to children. This poses an immediate risk to the health, safety or personal rights of children in care.
	POC Due Date: 06/04/2019
	Plan of Correction
1 2 3 4	Licensee will ensure all medications will be identified by child's name and shall be dated when stored in a locked container/cabinet at all times. Licensee will send photo of prescribed medication listing all required information for child receiving medication.

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: Diana deLeon	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Peter Espinoza	TELEPHONE: 661-644-8231
LICENSING EVALUATOR SIGNATURE:	DATE: 06/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/03/2019

LIC809 (FAS) - (06/04)

Page: 3 of 4

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: MAOF CESAR CHAVEZ PRESCHOOL	FACILITY NUMBER: 153808652
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/03/2019

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.7995(a)(1)

Staff Records - General Provisions and Definitions

(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.
	Deficient Practice Statement
1 2 3 4	This requirement is not met as evidenced by records review conducted during today’s inspection. Upon review of staff personnel files, LPA's were unable to observe proof of influenza vaccinations for S-2,3,4,5,& 6. This poses an potential risk to the health, safety or personal rights of children in care.
	POC Due Date: 06/10/2019
	Plan of Correction
1 2 3 4	During today's inspection, Licensee provided obtained declination form for S-2, 3, 4, 5, & 6. Deficiency cleared at visit

Type B

Section Cited

CCR

101217(a)(11)

Staff Records - Personnel Records

(a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information: (11) A health screening as specified in Section 101216(g).
	Deficient Practice Statement
1 2 3 4	This requirement is not met as evidenced by records review conducted during today’s inspection. A review of personnel records indicate no Health Screening for S-1. This poses an potential risk to the health, safety or personal rights of children in care.
	POC Due Date: 06/03/2019
	Plan of Correction
1 2 3 4	Site Supervisor obtained copy of Health Screening for S-1 prior to end of inspection and placed copy in personnel file of S-1. Deficiency Cleared at visit.

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: Diana deLeon	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Peter Espinoza	TELEPHONE: 661-644-8231
LICENSING EVALUATOR SIGNATURE:	DATE: 06/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/03/2019

LIC809 (FAS) - (06/04)

Page: 4 of 4