240402103-3-3-2023-04-CC-PZAO-CPKUFE-20230303143237

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 240402103
Report Date: 03/03/2023
Date Signed: 03/03/2023 02:32:49 PM

Document Has Been Signed on 03/03/2023 02:32 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:	OUR LADY OF MERCY PRESCHOOL		FACILITY NUMBER:	240402103
ADMINISTRATOR:	JASSO, VERONICA		FACILITY TYPE:	850
ADDRESS:	1400 EAST 27TH STREET		TELEPHONE:	(209) 722-6657
CITY:	MERCED	STATE: CA	ZIP CODE:	95340
CAPACITY:	87	CENSUS: 26	DATE:	03/03/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Rosa Hermosillo		TIME COMPLETED:	02:45 PM

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	On 3/3/2023, Licensing Program Analyst (LPA) Priscilla Zamudio and Licensing Program Manager (LPM) Cynthia Brannon, conducted an unannounced Annual Required Inspection for the preschool license. LPA met with Teacher, Rosa Hermosillo, (designated in Director’s absence), took a census, toured the facility indoors and outdoors. Days and hours of operation are Monday – Friday, 7:30am-5:30pm. LPA verified the facility phone number is (209) 722-6657. There are four classrooms in the facility. Classrooms A and B are in the modular building, and classrooms 9 and 10 are part of the elementary school site. 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, medication 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. The climbing structure does not have an age-appropriate sticker to reflect that the structure is safe for the preschool children. Per staff, the structure was installed estimated five years ago. Outdoor activity space is currently off-limits due to construction. The following items should be addressed prior to use of the outdoor space: hole in chain-link fence, long screws on fence poles, overgrown vines hanging over fence, inspect logs around sandbox to ensure children are free from obtaining splinters, dump any stationary water on play equipment, and install the age appropriate sticker on climbing equipment, and to ensure the cracks on the black top does not become a tripping hazard to children in care. Licensee has been informed to schedule and appointment with LPA to inspect the outside play yard before children are allowed to use the outside play yard. LPA left her business card to provide her contact information. During today's inspection, staff informed LPM that ill children are isolated in the room and use well children's restroom. The purpose of isolating a sick child is to ensure other children do not get ill. The ill child is to use staff restroom and isolation in another room.

SUPERVISOR'S NAME: Cynthia Brannon	TELEPHONE: (559) 650-7884
LICENSING EVALUATOR NAME: Priscilla Zamudio	TELEPHONE: (559) 578-7350
LICENSING EVALUATOR SIGNATURE:	DATE: 03/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2023

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 4

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: OUR LADY OF MERCY PRESCHOOL	FACILITY NUMBER: 240402103
	VISIT DATE: 03/03/2023

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
26
27
28
29
30
31
32

The children’s restroom near classrooms 9 and 10, have a broken tile in the girl’s restroom, rust on the stall dividers in both children’s restrooms and the toilet base floor screws are rusted and do not have a cover. In the girl’s restroom, one of the stalls has an out of service sign and water is leaking from the toilet, leaving water draining into the floor drain. This is a possible slipping hazard. Floors in the facility are clean and safe. Children bring their own lunches from home. Facility provides snacks. 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. Drinking water is available both indoors and outdoors. Water has been tested for lead and is in compliance. Areas around high climbing equipment, swings and slides have cushioning material to absorb falls. The facility is free of flies, insects and rodents. Facility has one or more functioning carbon monoxide detectors that meet statutory requirements.

Facility representative 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.

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. The name of the child care center director or fully-qualified teacher(s) 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.
Incidental Medical Services (IMS) are not currently being provided.

SUPERVISOR'S NAME: Cynthia Brannon	TELEPHONE: (559) 650-7884
LICENSING EVALUATOR NAME: Priscilla Zamudio	TELEPHONE: (559) 578-7350
LICENSING EVALUATOR SIGNATURE:	DATE: 03/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2023

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
FRESNO-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: OUR LADY OF MERCY PRESCHOOL	FACILITY NUMBER: 240402103
	VISIT DATE: 03/03/2023

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
26
27
28
29
30
31
32

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

LPA and Lead Teacher 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.

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, the following deficiency is being cited: (see next page, 809 D) Facility Representative was provided a copy of the appeal rights.

Exit interview conducted and report was reviewed with the facility representative Rosa Hermosillo.
A notice of site visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Cynthia Brannon	TELEPHONE: (559) 650-7884
LICENSING EVALUATOR NAME: Priscilla Zamudio	TELEPHONE: (559) 578-7350
LICENSING EVALUATOR SIGNATURE:	DATE: 03/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2023

LIC809 (FAS) - (06/04)

Page: 3 of 4

Document Has Been Signed on 03/03/2023 02:32 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: OUR LADY OF MERCY PRESCHOOL	FACILITY NUMBER: 240402103
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/03/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101238(a)

(a) The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the licensee did not comply with the section cited above in that the children’s restroom near classrooms 9 and 10, have a broken tile in the girl’s restroom, rust on the stall dividers in both children’s restrooms and the toilet base floor screws are rusted and do not have a cover. In the girl’s restroom, one of the stalls has an out of service sign and water is leaking from the toilet, leaving water draining into the floor drain. This poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 03/17/2023
	Plan of Correction
1 2 3 4	Facility Representative will contact repair service to have items fixed. They will contact licensing when completed.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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: Cynthia Brannon	TELEPHONE: (559) 650-7884
LICENSING EVALUATOR NAME: Priscilla Zamudio	TELEPHONE: (559) 578-7350
LICENSING EVALUATOR SIGNATURE:	DATE: 03/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2023

LIC809 (FAS) - (06/04)

Page: 4 of 4