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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 243808262
Report Date: 05/21/2019
Date Signed: 05/21/2019 03:52:57 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:WESTSIDE HEAD START/EARLY HEAD STARTFACILITY NUMBER:
243808262
ADMINISTRATOR:PEREZ, VICKYFACILITY TYPE:
850
ADDRESS:805 TEXASTELEPHONE:
(209) 826-3483
CITY:LOS BANOSSTATE: CAZIP CODE:
93635
CAPACITY:56CENSUS: 35DATE:
05/21/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Roxann Garcia, Site SupervisorTIME COMPLETED:
04:10 PM
NARRATIVE
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An unannounced/annual required inspection was conducted today by Licensing Program Analysts (LPAs), Daniel Alvarez and Stephanie Navarro. LPAs met with Site Supervisor, Roxann Garcia. LPAs toured the facility, both indoors and outdoors. This is a three-classroom facility. There are no firearms present at this facility. 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. No poisons were observed during today’s inspection. All materials and surfaces accessible to children are toxic free. All toilets, and bathing facilities are in safe and sanitary operating conditions. All floors are clean and safe. Furniture and equipment are in good condition, free of sharp, loose, or pointed parts. Solid waste storage vessels, including moveable bins, have tight-fitting covers on, are in good repair. Drinking water is available both indoors and outdoors. All foods/beverages capable of rapid spoiling are stored in covered containers at 45 (F) or less. Menus are posted at least one week in advance, where an authorized representative can view them. LPAs observed tree roots protruding above the ground in several areas in the outdoor toddler play area, resulting in potential a tripping hazard to children in care. Areas around high climbing equipment, swings, and slides have cushioning material to absorb falls. Staff records contain appropriate, documentation of education credits. At least one person trained in CPR and Pediatric first-aid is present when children are at the facility or at off-site activities. Child's admission agreement is available for review. Meals and snacks are prepped in the on-site kitchen facility and served to children in the classrooms. Required CCL forms are posted on parent's board.
SUPERVISOR'S NAME: Duane MatsubaraTELEPHONE: (559) 650-7855
LICENSING EVALUATOR NAME: Daniel Q AlvarezTELEPHONE: (559) 341-8684
LICENSING EVALUATOR SIGNATURE:

DATE: 05/21/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2019
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
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: WESTSIDE HEAD START/EARLY HEAD START
FACILITY NUMBER: 243808262
VISIT DATE: 05/21/2019
NARRATIVE
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Incidental Medical Services (IMS) policy was discussed. Facility is not providing IMS services at this time. 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.

LPAs discussed the Community Care Licensing website, Lead Safety, Safe Sleep, and Mandated Reporter Training: LPA and licensee discussed new additions to the website that include the new PIN (Provider Information Notification) and information for providers including the Quarterly Update that informs licensees of new legislation and regulations. Please follow these steps go to http://www.cdss.ca.gov/, click on “information and resources” click “Community Care Licensing” Click “quarterly updates” click “Child Care advocates program” and register to PIN.

Per Chapter 1, Division 12, Title 22 of the California Code of Regulations the following deficiencies are cited on LIC 809-D. Site Supervisor was handed a copy of appeal rights. Exit interview was conducted with Roxann Garcia.

THIS REPORT SHALL BE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. LIC 9213 NOTICE OF SITE INSPECTION FORM IS REQUIRED TO BE POSTED FOR 30 DAYS.
SUPERVISOR'S NAME: Duane MatsubaraTELEPHONE: (559) 650-7855
LICENSING EVALUATOR NAME: Daniel Q AlvarezTELEPHONE: (559) 341-8684
LICENSING EVALUATOR SIGNATURE:

DATE: 05/21/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2019
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: WESTSIDE HEAD START/EARLY HEAD START
FACILITY NUMBER: 243808262
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/21/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/22/2019
Section Cited
CCR
101170(e)(1)
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Criminal Record Clearance. Prior to working or volunteering in a licensed child care facility, all individuals subject to a criminal record review shall obtain a clearance or criminal record exemption. This requirement was not met as evidenced by records review and LPAs observation.
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Site Supervisor Roxann Garcia made an Live Scan appointment for Staff #1 for today and understands staff #1 is not able to come back to work until she receives her fingerprint clearance.
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Today, LPAs witnessed Staff #1 caring for children in Room #1. Staff #1 does not have proof of fingerprint clearance, nor is clearance reflected in LIS computer system. This poses an immediate health, safety or personal rights risks to children in care. An immediate Civil Penalty will not be issued since the licensee is a public entity. The Department of Education will be notified.
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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: Duane MatsubaraTELEPHONE: (559) 650-7855
LICENSING EVALUATOR NAME: Daniel Q AlvarezTELEPHONE: (559) 341-8684
LICENSING EVALUATOR SIGNATURE:

DATE: 05/21/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2019
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: WESTSIDE HEAD START/EARLY HEAD START
FACILITY NUMBER: 243808262
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/21/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/21/2019
Section Cited
CCR
101238.2(c)
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(c) Equipment and activity areas shall be arranged so that there is no hazard from conflicting activities.
This requirement is not met as evidenced by observation and interview conducted during today’s inspection. LPAs observed tree roots protruding above the ground in several areas in the outdoor toddler play area, resulting in a tripping hazard to children in care. This poses a potential risk to health, safety, or personal rights of children in care.
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Site Supervisor agreed to submit proof of work order for tree roots to be addressed to Community Care Licensing Fresno Regional Office by 6/21/2019.
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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: Duane MatsubaraTELEPHONE: (559) 650-7855
LICENSING EVALUATOR NAME: Daniel Q AlvarezTELEPHONE: (559) 341-8684
LICENSING EVALUATOR SIGNATURE:

DATE: 05/21/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2019
LIC809 (FAS) - (06/04)
Page: 4 of 4