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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 203808070
Report Date: 03/14/2022
Date Signed: 03/14/2022 01:26:46 PM


Document Has Been Signed on 03/14/2022 01:26 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
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710



FACILITY NAME:RUTH GONZALES HEAD START CENTERFACILITY NUMBER:
203808070
ADMINISTRATOR:RAMIREZ, SOCORROFACILITY TYPE:
850
ADDRESS:838 LILLY STREETTELEPHONE:
(559) 675-8518
CITY:MADERASTATE: CAZIP CODE:
93638
CAPACITY:20CENSUS: 13DATE:
03/14/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Socorro RamirezTIME COMPLETED:
02:00 PM
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On March 14, 2022 Licensing Program Analyst (LPA) Brannon, conducted an unannounced Annual Required Inspection for the preschool license. LPA met with Site Supervisor, Socorro Ramirez, and toured the facility indoors and outdoors. Days and hours of operation are Monday through Friday, 8 AM to 1 PM. Site Supervisor verified facility phone number is (559) 675-8518. Breakfast and lunch are provide to the children in care.

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 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. Playground equipment is in safe condition, free of sharp, loose or pointed parts. During today’s inspection, LPA observed that the climbing structure is missing the age appropriate sticker. Areas around high climbing equipment, swings and slides have cushioning material to absorb falls. This facility utilizes wood chip for cushioning around the climbing structure. LPA recommends for licensee to have the excess wood chip cushioning raked into the fall zones around climbing structure. There are two shade structures providing shade for children in care while playing outside.

During today’s inspection, LP observed a hole, in the cement. The hole appears to be from a removed metal fencing pole. This is located between two metal poles for chain link fencing. This area is an entry way leading into a grass area for the children to play.

All toilets and hand washing facilities are in safe and sanitary operating condition. Floors in the facility are clean and safe. All kitchen, food preparation and storage areas are clean, free of litter/rubbish and free of rodents/vermin. 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.

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SUPERVISOR'S NAME: Michael DuarteTELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Cynthia BrannonTELEPHONE: (559) 388-3635
LICENSING EVALUATOR SIGNATURE:
DATE: 03/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/14/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: RUTH GONZALES HEAD START CENTER
FACILITY NUMBER: 203808070
VISIT DATE: 03/14/2022
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Drinking water is available both indoors and outdoors. To provide non-contaminated drinking water, licensee has provided a cup dispenser to be used with disposable cups for the outside. Licensee does not provide disposable cup dispenser for the inside drinking water; to ensure non-contaminated drinking water for children in care.

The facility is free of flies, insects and rodents. Facility has one or more functioning carbon monoxide detectors that meet statutory requirements. Fire/Earthquake/Lock down drills are conducted and documented monthly.

Parents do not come into the facility to sign their children in/out. Instead, they are walking into the outside play yard to have their children’s health check and speak to staff. During today’s inspection, LPA observed parents waiting outside the chain link fencing area for facility to open. The parents were not near the area of licensing postings. LPA is recommending that all required licensing forms be posted where the parents are signing their child in/out; which is a prominent area for parents’ viewing.

During today’s visit, LPA reviewed with Area Manager, Angela Martinez, Title 22, section 101218.1: Admission Procedures and Parental and Authorized Representative Rights, including H & S code 1596.87: Upon presentation of identification, the responsible parent or guardian of a child receiving services in a child day care facility has the right to enter and inspect the facility without advance notice during the normal operation hours of a facility. Parent or guardians when inspecting shall be respectful of the children’s routines and programmed activities. The facility shall inform parents and guardians of children receiving services in the facility of the right of parents and guardians to inspect the facility pursuant to this section.

Site Supervisor, Socorro Ramirez, 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. Upon notification from the Department, the licensee will comply and act immediately to terminate the employment of, remove from the facility or bar from entering the facility for any person it is deemed necessary while the Department considers granting or denying an exemption.

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SUPERVISOR'S NAME: Michael DuarteTELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Cynthia BrannonTELEPHONE: (559) 388-3635
LICENSING EVALUATOR SIGNATURE:

DATE: 03/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2022
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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
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: RUTH GONZALES HEAD START CENTER
FACILITY NUMBER: 203808070
VISIT DATE: 03/14/2022
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Capacity and limitations as specified on the license are being maintained. At least one person trained in CPR and Pediatric First Aid is present when children are at the facility or at offsite activities. Ruth Gonzales Head Start Center site supervisor designated to act in the director’s absence has been reported to the Department.

The person who signs the child in/out of the facility shall use their full legal signature and record the time of day. All children are under supervision, including visual supervision, of a teacher at all times. Facility maintains a ratio of one teacher supervising no more than 12 children in care. LPA reviewed a sample of children’s files and observed files were complete with contact information for authorized representative and or relatives or others who can assume responsibility for the child and medical assessment.

LPA reviewed a sample of 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. Menus are posted at least one week in advance where an authorized representative can view them.

Per site supervisor, there are no children requiring Incidental Medical Services (IMS). IMS policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes 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

Currently, licensee does not have an infant program. For future reference, LPA discussed the safe sleep regulations with Site Supervisor, Socorro Ramirez, 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 site supervisor 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.


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SUPERVISOR'S NAME: Michael DuarteTELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Cynthia BrannonTELEPHONE: (559) 388-3635
LICENSING EVALUATOR SIGNATURE:

DATE: 03/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2022
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: RUTH GONZALES HEAD START CENTER
FACILITY NUMBER: 203808070
VISIT DATE: 03/14/2022
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LPA and site supervisor 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, Safe Sleep in Child Care, Lead Poisoning Facts, Forms and Regulations.

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.

The following documents should be posted at the facility:


Ø PUB 269 – child passenger restraint systems poster
Ø PUB 393 – Notification of Parents Rights
Ø License
Ø Menus
Ø LIC 613A – Personal Rights form
Ø LIC 610 – Disaster Plan
Ø LIC 9148 – Earthquake Preparedness Checklist

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies are cited.

Exit interview conducted and report was reviewed with Site Supervisor, Socorro Ramirez.

This report shall be made available to the public upon request. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISOR'S NAME: Michael DuarteTELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Cynthia BrannonTELEPHONE: (559) 388-3635
LICENSING EVALUATOR SIGNATURE:

DATE: 03/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2022
LIC809 (FAS) - (06/04)
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