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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 203810070
Report Date: 07/12/2019
Date Signed: 07/12/2019 09:38:09 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:YOSEMITE LAKES COMMUNITY CHURCH KIDS IN CHRISTFACILITY NUMBER:
203810070
ADMINISTRATOR:HECKMAN, BRENDAFACILITY TYPE:
840
ADDRESS:43840 PATRICK AVETELEPHONE:
(559) 440-6777
CITY:COARSEGOLDSTATE: CAZIP CODE:
93614
CAPACITY:45CENSUS: 14DATE:
07/12/2019
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
07:00 AM
MET WITH:Dicey WheatonTIME COMPLETED:
10:00 AM
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 A pre-licensing inspection visit was conducted on this date by Licensing Program Analyst (LPA) Brannon, who met with lead teacher, Dicie Wheaton. The center is located at Yosemite Lakes Community Church. The licensee is requesting a school-age capacity of 45 children. This program will operate year round. Summer hours of operation is from 7:00 am to 6:00 pm, Monday thru Friday. When school is in session, hours of operation is 2:45 pm to 6:00 pm, Monday thru Friday; however, on Mondays and Wednesdays, the school age children will arrive at 1:45 pm to 6:00 pm. This facility provides morning and afternoon snack. Licensee is aware that the snack menu needs to be posted. Parents provide for their child(ren)'s lunch. Per lead teacher, parents will have an ice pack in the children's lunch sack if contents need to be kept cool. If the parent forgets to bring their child's lunch, the parent is called. There is a microwave and a small size refrigerator in the classroom. There is no kitchen due to not having to prepare food. Ill children and staff will utilize the bathroom located in the chapel. Ill children will be isolated in the chapel. Staff is aware that one staff will be required to stay with the child until child is picked up by parent. Room measurements taken and reviewed with Dicie Wheaton. There are two portables that will be used by school age children. The total school age classroom square footage is 1480, which will accommodate 42 school age children. CONTINUED ON THE FOLLOWING PAGE
SUPERVISOR'S NAME: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Cynthia BrannonTELEPHONE: (559) 341-5155
LICENSING EVALUATOR SIGNATURE:

DATE: 07/12/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2019
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: YOSEMITE LAKES COMMUNITY CHURCH KIDS IN CHRIST
FACILITY NUMBER: 203810070
VISIT DATE: 07/12/2019
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The following items must be completed prior to issuing a license by 7/24/19:
1. A waiver for sharing the outside play yard with the preschool, and a copy of the outside play yard schedule showing when the preschool and school age children are utilizing the play yard.
2. The bathrooms in portable 1 and in portable 2 have tall cabinets with items stored on top. These items are to be removed.
3. Portable 2 bathroom has rust on the wall under the sink. This area shall be repaired.
4. In the walk way that the children use to go to the outside play area has wooden boards that need to be removed.
5. Licensee is required to have a drinking water source for the children in each portable classroom. Licensee cannot use the bathroom sink as drinking water. LPA was informed that two igloos with disposable cup dispensers and disposable cups will be utilized in the classrooms. Water from the church kitchen will be used for inside drinking water. Due to high temperatures, LPA recommended that the water be replaced throughout the day.
6. Director and staff shall have their fingerprint clearance added to the school age license.

CONTINUED ON THE FOLLOWING PAGE
SUPERVISOR'S NAME: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Cynthia BrannonTELEPHONE: (559) 341-5155
LICENSING EVALUATOR SIGNATURE:

DATE: 07/12/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2019
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: YOSEMITE LAKES COMMUNITY CHURCH KIDS IN CHRIST
FACILITY NUMBER: 203810070
VISIT DATE: 07/12/2019
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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 taken on this date total 10080 square feet which will accommodate the capacity of 42 school age children. Adequate shade is available in the outdoor activity area. The applicant is using wood chips for cushioning under the outdoor climbing structure.
There are 3 toilets and 3 sinks/hand washing fixtures in the children's bathrooms which will accommodate 42 children. There is a drinking water fountain, which will be utilized for outdoor drinking water.
The fire clearance has been received and approved for 45 children, however, the inside square footage will allow for 42 school age children. LPA reviewed with lead teacher that a fire drill log is required. Fire drills should be conducted at least every 6 months.
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
CONTINUED ON THE FOLLOWING PAGE
SUPERVISOR'S NAME: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Cynthia BrannonTELEPHONE: (559) 341-5155
LICENSING EVALUATOR SIGNATURE:

DATE: 07/12/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2019
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: YOSEMITE LAKES COMMUNITY CHURCH KIDS IN CHRIST
FACILITY NUMBER: 203810070
VISIT DATE: 07/12/2019
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Pending a final file review and completion of above items, a recommendation will be made to license the above facility for a capacity of 42 school age children. Licensee shall
Please update LIC 500, LIC 610, LIC 308, Facility Sketch upon licensure.

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)

Exit interview conducted with lead teacher, Dicie Wheaton.

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

SUPERVISOR'S NAME: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Cynthia BrannonTELEPHONE: (559) 341-5155
LICENSING EVALUATOR SIGNATURE:

DATE: 07/12/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2019
LIC809 (FAS) - (06/04)
Page: 4 of 4