243808254-10-4-2019-04-CC-CBRN-BGMNYL-20191004105255

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 243808254
Report Date: 10/04/2019
Date Signed: 10/04/2019 10:53:02 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:	LE GRAND HEAD START		FACILITY NUMBER:	243808254
ADMINISTRATOR:	CHRISTINA ROBLES		FACILITY TYPE:	850
ADDRESS:	13071 EAST LE GRAND ROAD		TELEPHONE:	(209) 389-4690
CITY:	LE GRAND	STATE: CA	ZIP CODE:	95333
CAPACITY:	30	CENSUS:	DATE:	10/04/2019
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Monica Garza		TIME COMPLETED:	11:15 AM

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	A prelicensing inspection visit was conducted on this date by Licensing Program Analyst (LPA) Brannon, who met with Assistant Director, Monica Garza. The center is located at Le Grand Elementary. The licensee is Merced County Office of Education. Licensee is decreasing capacity from 30 to 20 preschool children. This program will operate traditional school-year, daily from 8:00 AM to 2:30 PM. Breakfast, lunch, and snacks will be provided and prepared by licensee's central kitchen that is located off site. There is a sink with hot water inside kitchen for food preparation. Ill children and staff will utilize the bathroom located near the classroom. Ill children will be isolated in director's office. Room measurements taken and reviewed with Monica Garza. Classroom #1 will be used by preschool children. The total preschool square footage is 681 which will accommodate 20 preschool children. Adequate storage space available for children's belongings. Outdoor storage is available for toys and equipment. Licensee has two locked sheds for outdoor storage. Toys and equipment are age appropriate. CONTINUED ON FOLLOWING PAGE

SUPERVISOR'S NAME: Michael Duarte	TELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Cynthia Brannon	TELEPHONE: (559) 341-5155
LICENSING EVALUATOR SIGNATURE:	DATE: 10/04/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2019

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: LE GRAND HEAD START	FACILITY NUMBER: 243808254
	VISIT DATE: 10/04/2019

NARRATIVE

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Outdoor measurements were not taken during today's visit. Licensee is decreasing capacity. Adequate shade is available in the outdoor activity area. The applicant is using wood chips for cushioning under the outdoor climbing structure.

There are 2 toilets and 2 sinks/hand washing fixtures in the children's bathrooms which will accommodate the requested capacity of 20 preschool children. Licensee is utilizing a water dispenser with disposable cups. Licensee is utilizing an igloo with plastic cups for the outside drinking water.

The fire clearance has been received and approved for 20 preschool children.

Licensee is providing Incidental Medical Services at this facility.

The following items must be completed prior to issuing a license by 10/18/19:
1. Disposable cup dispensers. One for the inside water dispenser, and one for the igloo that is utilized for the outside water source
2. The permanent shade structure poles do have cushioning, however, the foam is showing. The cushioning need to be replaced.
3. The climbing structure is missing the sticker that states the appropriate age for this equipment.
4. The exterior wall facing the outside play area has jagged edges. This area needs to be replaced or repaired to ensure the safety of the children in care.
5. There is rust on the ramp in front of the door leading into the classroom. The rust appears to have a bubbling appearance. The rust issue needs to be addressed and corrected.

CONTINUED ON FOLLOWING PAGE

SUPERVISOR'S NAME: Michael Duarte	TELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Cynthia Brannon	TELEPHONE: (559) 341-5155
LICENSING EVALUATOR SIGNATURE:	DATE: 10/04/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2019

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: LE GRAND HEAD START	FACILITY NUMBER: 243808254
	VISIT DATE: 10/04/2019

NARRATIVE

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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 20 preschool children.

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)

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

SUPERVISOR'S NAME: Michael Duarte	TELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Cynthia Brannon	TELEPHONE: (559) 341-5155
LICENSING EVALUATOR SIGNATURE:	DATE: 10/04/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2019

LIC809 (FAS) - (06/04)

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