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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 203801809
Report Date: 05/24/2023
Date Signed: 05/24/2023 04:52:34 PM


Document Has Been Signed on 05/24/2023 04:52 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-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710



FACILITY NAME:MADERA CHILD DEVELOPMENT CENTER*FACILITY NUMBER:
203801809
ADMINISTRATOR:GARCIA, RACHELFACILITY TYPE:
850
ADDRESS:1205 SONORA STREETTELEPHONE:
(559) 674-1972
CITY:MADERASTATE: CAZIP CODE:
93638
CAPACITY:84CENSUS: 60DATE:
05/24/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:01 PM
MET WITH:Veronica Hurtado de O'Donvan TIME COMPLETED:
05:15 PM
NARRATIVE
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On 5/24/2023, Licensing Program Analyst (LPA) Stephanie Vega-Gonzalez conducted an unannounced case management inspection at facility. LPA met with Supervisor, Veronica Hurtado de O’Donovan who accompanied LPA during tour of facility both inside and outside.

During today's inspection LPA toured facility and observed in the kitchen that staff was using a blue dishwasher rack to drain spaghetti. LPA observed that spaghetti was going to be served to children on today's date. LPA spoke to kitchen (Staff 1) and Supervisor regarding usage of a dishwasher rack for food preparation. LPA reviewed 101227 Food Service regulations. Supervisor stated they understood.

During today's inspection LPA was made aware that the air conditioning system in classroom 2 was not operable for May 17th, 18th, and 19th and children had to be moved to other classrooms. LPA noted Community Care Licensing was not informed of this incident. LPA reviewed 101212 Reporting Requirements regulation. Supervisor stated they understood.

Per California Code of Regulations, Title 22, Division 12, Chapter 1, these deficiencies are being cited on the attached LIC 9099D).

An exit interview conducted with Supervisor, Veronica Hurtado de O’Donovan. A copy of this report and Appeal Rights were provided and discussed with Supervisor, Veronica Hurtado de O’Donovan.
A Notice of Site Visit Form was posted to parent's board and must remain posted for 30 days.
SUPERVISOR'S NAME: Juvenal MoctezumaTELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Stephanie Vega-GonzalezTELEPHONE: (559) 575-6900
LICENSING EVALUATOR SIGNATURE:
DATE: 05/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/24/2023
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 2


Document Has Been Signed on 05/24/2023 04:52 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-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710


FACILITY NAME: MADERA CHILD DEVELOPMENT CENTER*
FACILITY NUMBER: 203801809

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/24/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/02/2023
Section Cited
CCR
101227(a)(1)

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101227 Food Services (a) In child care centers providing meals to children, the following shall apply: (1) All food shall be safe and of the quality and in the quantity necessary to meet the needs of the children. Each meal shall include . . . This requirement was not met as evidenced by, LPA observed
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Supervisor stated that they will hold a meeting with staff #1 on proper food handling and provide proof of meeting to Community Care Licensing by POC due date.
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kitchen staff #1 using a dishwasher rack to drain spaghetti as stated in LIC809. This poses an potential health/risk to children in care.
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Type B
06/02/2023
Section Cited
CCR101212(d)

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101212(d)Reporting Requirements
(d) Upon the occurrence, during the operation of the child care center of any of the events specified in (d)(1) below, a report shall be made to the Department by telephone or fax within the Department's next working day and during its normal . . .
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Supervisor stated that they will call in the unusual incident to Community Care Licensing and submit a UIR LIC624 report Community Care Licensing by POC due date.
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This requirement was not met as evidenced through record review incident had not been called in to Community Care Licensing as stated in LIC809. This poses an potential health/risk to children in care
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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: Juvenal MoctezumaTELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Stephanie Vega-GonzalezTELEPHONE: (559) 575-6900
LICENSING EVALUATOR SIGNATURE:
DATE: 05/24/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/24/2023
LIC809 (FAS) - (06/04)
Page: 2 of 2