243801216-9-24-2019-04-CC-JPAO-BGBQYR-20190924123534

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 243801216
Report Date: 09/24/2019
Date Signed: 09/24/2019 12:35:47 PM

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:	JOHN MUIR PRESCHOOL		FACILITY NUMBER:	243801216
ADMINISTRATOR:	COLE, MELANIE		FACILITY TYPE:	850
ADDRESS:	300 W. TWENTY-SIXTH STREET		TELEPHONE:	(209) 385-6667
CITY:	MERCED	STATE: CA	ZIP CODE:	95340
CAPACITY:	21	CENSUS: 18	DATE:	09/24/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	11:05 AM
MET WITH:	Kelly Sizemore - Lead Teacher		TIME COMPLETED:	12:50 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	(2) Licensing Program Analyst, Joseph Pacheco, conducted an unannounced annual/random inspection today. LPA met with Lead Teacher, Kelly Sizemore and a tour of the facility was conducted inside and outside. Staff and children 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. Food is prepared at the adjacent elementary school and transported by staff before the beginning of the AM and PM sessions. Food and beverages are stored in covered containers at 45 degrees F or less if required, and 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. Staff are fingerprint cleared as a condition of employment through Merced City School District. No excluded individuals are present. Teacher-child ratios are maintained and adequate supervision was observed during today’s inspection. First Aid/CPR credentials were reviewed and expire on 6/11/2020. AB 1207 Mandated Reporter certification for staff is current and expires in August of 2021. Sign in/sign out sheets are maintained. Children’s records were reviewed to ensure proper forms are located within each child’s file. Staff records contain documentation of education, training, and/or experience. Menus are posted. This facility operates an AM and PM session. AM session is 7:45am – 10:45am. PM session is 11:35am – 2:35pm. Both AM and PM sessions are Monday through Friday. Incidental Medical Services (IMS) policy was discussed. Incidental Medical Services (IMS) are not currently being provided. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: CONTINUED ON 809-C

SUPERVISOR'S NAME: Diana deLeon	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Joseph Pacheco	TELEPHONE: (559) 341-4457
LICENSING EVALUATOR SIGNATURE:	DATE: 09/24/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2019

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: JOHN MUIR PRESCHOOL	FACILITY NUMBER: 243801216
	VISIT DATE: 09/24/2019

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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

An exit interview was conducted with Lead Teacher, Kelly Sizemore. LPA provided Teacher with information regarding providing incidental medical services to children, the CDSS Provider Information Notices (PINs) communication system, and some important resources and information links offered on the CDSS website.

A copy of this report must remain in the facility for public review.

No deficiencies were observed during today's visit.

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 deLeon	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Joseph Pacheco	TELEPHONE: (559) 341-4457
LICENSING EVALUATOR SIGNATURE:	DATE: 09/24/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2019

LIC809 (FAS) - (06/04)

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