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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 203808503
Report Date: 01/21/2020
Date Signed: 01/21/2020 11:27:45 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 PRESCHOOLFACILITY NUMBER:
203808503
ADMINISTRATOR:THARP, CINDYFACILITY TYPE:
850
ADDRESS:208 FIG TREE ROADTELEPHONE:
(559) 665-1182
CITY:CHOWCHILLASTATE: CAZIP CODE:
93610
CAPACITY:60CENSUS: 31DATE:
01/21/2020
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Marlene Parreira - Lead TeacherTIME COMPLETED:
11:45 AM
NARRATIVE
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Licensing Program Analyst (LPA), Joseph Pacheco, conducted an unannounced annual/random inspection today. LPA met with Lead Teacher, Marlene Parreira, and a tour of the facility was conducted inside and outside. Staff were spoken to during visit. The following areas were in compliance during today’s inspection: There are no bodies of water present at this facility. There are no firearms or ammunition allowed on the premises. Disinfectants, hazardous items and medications are inaccessible to children. Storage area for poisons is locked. Furniture and equipment are sufficient, age appropriate and in good repair. The playground equipment and outdoor activity space is maintained and in good condition with adequate cushioning material. Children's toilets, hand washing facilities are sanitary. Rooms are safe and clean. Snacks are provided and children in the full day session bring their own lunch. Storage containers for solid waste are covered. Drinking water is available both indoors and outside. Measures are taken to keep facility free of insects and rodents. Sign in/sign out sheets are maintained. Children’s records were reviewed to ensure proper forms are located within each child’s file. Menus are posted. An annual continuation visit will be needed to review staff files due to the absence of Director. Lead Teacher was unable to provide necessary documents to LPA during today’s inspection.

Hours of operation are 8:00am – 5:00pm, Monday through Friday.

An exit interview was conducted with Lead Teacher, Marlene Parreira. A copy of this report must remain in the facility for public review.

Per Chapter 1, Division 12, Title 22 of the California Code of Regulations, the following deficiencies are found (see LIC809-D):

Copy of appeal Rights left with center representative/licensee.

CONTINUED ON LIC809-C
SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Joseph PachecoTELEPHONE: (559) 341-4457
LICENSING EVALUATOR SIGNATURE:

DATE: 01/21/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2020
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 3
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: 01/21/2020
NARRATIVE
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THIS REPORT SHALL BE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS.
SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Joseph PachecoTELEPHONE: (559) 341-4457
LICENSING EVALUATOR SIGNATURE:

DATE: 01/21/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2020
LIC809 (FAS) - (06/04)
Page: 3 of 3
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/21/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/31/2020
Section Cited

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Teacher Aide Qualifications and Duties- An aide shall work only under the direct supervision of a teacher. This requirement was not met as evidenced by LPA observing that Teacher #1 took Child #1 to the bathroom
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while Aide #1 stayed inside the classroom caring for 8 children. The bathroom was outside the classroom in a hallway. This is a potential risk to the health, safety or personal rights of children in care.
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Type B
01/31/2020
Section Cited

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Personnel Records. All personnel records shall be available to the Department to inspect, audit, and copy upon demand during normal business hours. This requirement was not met as evidenced by LPA observation that facility records were unavailable for review for five of the eight staff.
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This is a potential risk to the health, safety or personal rights of 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: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Joseph PachecoTELEPHONE: (559) 341-4457
LICENSING EVALUATOR SIGNATURE:
DATE: 01/21/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/21/2020
LIC809 (FAS) - (06/04)
Page: 2 of 3