203808503-8-26-2019-04-CC-CBRN-BFEMNT-20190826094603

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 203808503
Report Date: 08/26/2019
Date Signed: 08/26/2019 09:46:10 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:	CORNERSTONE COMMUNITY CHURCH PRESCHOOL		FACILITY NUMBER:	203808503
ADMINISTRATOR:	THARP, CINDY		FACILITY TYPE:	850
ADDRESS:	208 FIG TREE ROAD		TELEPHONE:	(559) 665-1182
CITY:	CHOWCHILLA	STATE: CA	ZIP CODE:	93610
CAPACITY:	45	CENSUS: 0	DATE:	08/26/2019
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	07:30 AM
MET WITH:	Cindy Tharp		TIME COMPLETED:	10:15 AM

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	A prelicensing inspection visit was conducted on this date by Licensing Program Analyst (LPA) Brannon, who met with Director Cindy Tharp. The center is located on the premises of Cornerstone Community Church located at 208 Fig Tree Road in Chowchilla. The licensee is requesting an increase in capacity from 45 to 60 preschool children. A fourth classroom that can be divided into two rooms has been added. This program will operate traditional school year, daily from 8:00 AM to 5:00 PM from Monday through Friday. Parents provide breakfast and lunch. Licensee will provide a snack. Hot water is not available in the classrooms. Ill children will utilize the bathroom located in the hallway by classroom # 4. Ill children will be isolated in director's office. Child will be isolated in the director's office until parent(s) pick up ill child. Room measurements taken and reviewed with director, Cindy Tharp. There are four classrooms that will be used by preschool children. The children will utilize the gymnasium and the bathrooms located in the gymnasium when climate dictates. The total preschool square footage is 2286 which will accommodate 60 preschool children. CONTINUED ON FOLLOWING PAGE

SUPERVISOR'S NAME: Michael Duarte	TELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Cynthia Brannon	TELEPHONE: (559) 341-5155
LICENSING EVALUATOR SIGNATURE:	DATE: 08/26/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2019

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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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: CORNERSTONE COMMUNITY CHURCH PRESCHOOL	FACILITY NUMBER: 203808503
	VISIT DATE: 08/26/2019

NARRATIVE

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Adequate storage space available for children's belongings. Outdoor storage is available for toys and equipment. Toys and equipment are age appropriate.

Outdoor measurements were taken on previous visit, 8/31/17, reflects 6003, which will accommodate the requested capacity of 60 preschool.

Adequate shade is available in the outdoor activity area. Licensee is utilizing a permanent shade structure. LPA is recommending that licensee utilize cushioning for the poles to help prevent a child from sustaining an injury when running into the metal pole. The applicant is using rubber pour-a-form for cushioning under the outdoor climbing structure.

There are 7 toilets, 3 urinals and 8 sinks/hand washing fixtures in the children's bathrooms which will accommodate the increased capacity of 60 preschool children. There is a drinking fountain for the outside play area. Classrooms have either water fountains or are utilizing disposable cups with dispensers.

The fire clearance has been received and approved for 60 preschool children.

Incidental Medical Services (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

CONTINUED ON FOLLOWING PAGE

SUPERVISOR'S NAME: Michael Duarte	TELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Cynthia Brannon	TELEPHONE: (559) 341-5155
LICENSING EVALUATOR SIGNATURE:	DATE: 08/26/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2019

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
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: CORNERSTONE COMMUNITY CHURCH PRESCHOOL	FACILITY NUMBER: 203808503
	VISIT DATE: 08/26/2019

NARRATIVE

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Pending a final file review, a recommendation will be made to license the above facility for a capacity of 60 preschool children.

The following documents should be posted at the facility:
* PUB 269- Child passenger restraint systems poster 101225(f) Transportation
* Pub 393- Notification of Parents Rights 101218.1(c) Admission Procedures
* License 101160(a) License
* Menus 101227(a)(6) Food Services
* LIC 613A- Personal Rights form 101223(b)(2) Personal Rights
* LIC 610- Disaster Plan 101174(a)
* LIC 9148- Earthquake Preparedness Checklist 101174(b)

To order forms, etc. visit our website at www.ccld.ca.gov.

SUPERVISOR'S NAME: Michael Duarte	TELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Cynthia Brannon	TELEPHONE: (559) 341-5155
LICENSING EVALUATOR SIGNATURE:	DATE: 08/26/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2019

LIC809 (FAS) - (06/04)

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