243808169-1-23-2023-04-CC-KVAG-CNCSTV-20230123131011

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 243808169
Report Date: 01/23/2023
Date Signed: 01/23/2023 01:10:24 PM

Document Has Been Signed on 01/23/2023 01:10 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:	AILEEN COLBURN PRESCHOOL		FACILITY NUMBER:	243808169
ADMINISTRATOR:	LAMERSON, LINDA		FACILITY TYPE:	850
ADDRESS:	2201 HELLER AVENUE		TELEPHONE:	(209) 357-6136
CITY:	ATWATER	STATE: CA	ZIP CODE:	95301
CAPACITY:	48	CENSUS: 23	DATE:	01/23/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Hope Ramirez		TIME COMPLETED:	12:00 PM

NARRATIVE

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On 01/23/2023, Licensing Program Analyst (LPA) Ka Vang conducted an unannounced Annual Required Inspection and was met by Assistant Teacher Hope Ramirez and Lead Preschool Teacher Tami Taber. This is an AM and PM half day program operates on a traditional school year schedule from August to June. This is facility has two separate classrooms, one classroom identified as Classroom 8, and the other classroom identified as Classroom 3. Both classes, including the AM and PM sessions, accounts for the license capacity of 48 children. Classroom 8 operates Monday-Friday, AM session starts from 8:15 AM to 11:15 AM, and PM session starts from 12:15 PM to 3:15 PM. Classroom 3 operates Monday-Friday, AM session starts 8:00 AM to 11:00 AM, PM session starts 12:00 PM to 3:00 PM. Breakfast and lunches are provided by the cafeteria staff delivered the food to the children in classrooms.

LPA toured the facility indoors and outdoors, and a census was taken. All children are under supervision, including visual supervision, of a teacher at all times. There is a ratio of one teacher supervising no more than 12 children in attendance. 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 to children. No poisons were observed during the inspection.

During the inspection, LPA observed furniture and equipment are in good condition, free of sharp, loose, or pointed parts. All toilets and handwashing facilities are in safe and sanitary operating condition. All floors are clean and safe. All kitchen, food preparation and storage areas are clean. The facility is free of flies, insects, and rodents. Facility has one or more functioning carbon monoxide detectors that meet the statutory requirements. Solid waste storage containers have tight-fitting covers and are in good repair. Drinking water is available both indoors and outdoors.

There is a working fire extinguisher, smoke detector, carbon monoxide detector and adequate heating and ventilation for safety and comfort in Classroom 8.

(Continued on LIC809-C).

SUPERVISOR'S NAME: Rene Mancinas	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Ka Vang	TELEPHONE: (559) 410-0327
LICENSING EVALUATOR SIGNATURE:	DATE: 01/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2023

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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Document Has Been Signed on 01/23/2023 01:10 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: AILEEN COLBURN PRESCHOOL	FACILITY NUMBER: 243808169
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/23/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.954

Licensure Requirements

Every licensed child day care center shall have one or more carbon monoxide detectors in the facility that meet the standards established in Chapter 8 (commencing with Section 13260) of Part 2 of Division 12. The department shall account for the presence of these detectors during inspections. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	During the indoor inspection of Classroom #3, LPA observed the classroom did not have a working carbon monoxide detector. Per Staff #3 (S3), the carbon monoxide detector was not working in the classroom and an order had been placed since December 2022; however, the classroom had not receive a working carbon monoxide yet. This poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 02/06/2023
	Plan of Correction
1 2 3 4	Per S3, she will ensure the Classroom #3 have a working carbon monoxide dectector by 02/06/2023. S3 will submit proof of correction to Community Care Licensing Office by 02/06/2023.

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: Rene Mancinas	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Ka Vang	TELEPHONE: (559) 410-0327
LICENSING EVALUATOR SIGNATURE:	DATE: 01/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2023

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

FACILITY NAME: AILEEN COLBURN PRESCHOOL	FACILITY NUMBER: 243808169
	VISIT DATE: 01/23/2023

NARRATIVE

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There is a working fire extinguisher and smoke detector and adequate heating and ventilation for safety and comfort in Classroom 3. LPA observed Classroom 3 did not had a working carbon monoxide detector which poses a potential health, safety or personal rights risk to persons in care. A citation of Type B deficiency cited during today’s inspection. Fire drills are conducted and documented with the date, time and how many children present, every six months.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Licensee was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record 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.

Upon notification from the Department, Licensee will comply and act immediately to terminate the employment of, remove from the facility or bar from entering the facility for any person it is deemed necessary while the Department considers granting or denying an exemption. 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. During record review, Staff #1 (S1) pediatric CPR/First Aid expires on 03/2023. S1’s Mandated Reporter training was completed on 08/25/2021. S2’s Mandated Reporter Training was completed on 8/25/21. S3’s Mandated Reporter Training was completed on 8/26/21. S4’s Mandated Reporter Training was completed on 8/26/21. S5’s Mandated Reporter Training was completed on 09/15/2022. 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.

(Continued on LIC 809-C).

SUPERVISOR'S NAME: Rene Mancinas	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Ka Vang	TELEPHONE: (559) 410-0327
LICENSING EVALUATOR SIGNATURE:	DATE: 01/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2023

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

FACILITY NAME: AILEEN COLBURN PRESCHOOL	FACILITY NUMBER: 243808169
	VISIT DATE: 01/23/2023

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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.

Incidental Medical Services (IMS) policy discussed, and facility is not providing IMS. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing 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: https://www.ada.gov/childqanda.htm.

LPA and 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.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

Per the California Code of Regulations, Title 22, Division 12, Chapter 1, there is deficiency been cited during today’s inspection. (see next page, 809 D).

Licensee was provided a copy of appeal rights. A notice of site visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Rene Mancinas	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Ka Vang	TELEPHONE: (559) 410-0327
LICENSING EVALUATOR SIGNATURE:	DATE: 01/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2023

LIC809 (FAS) - (06/04)

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