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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 243808275
Report Date: 02/14/2023
Date Signed: 02/14/2023 12:17:58 PM


Document Has Been Signed on 02/14/2023 12:17 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:MITCHELL HEAD STARTFACILITY NUMBER:
243808275
ADMINISTRATOR:FLORES, VIRGINIAFACILITY TYPE:
850
ADDRESS:1791 GROVE AVENUETELEPHONE:
(209) 381-5183
CITY:ATWATERSTATE: CAZIP CODE:
95301
CAPACITY:20CENSUS: 0DATE:
02/14/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Kiana SanajouyahTIME COMPLETED:
12:25 PM
NARRATIVE
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On 02/14/2023, Licensing Program Analyst (LPA) Ka Vang conducted an unannounced Annual Required Inspection and was met by Facility Representative Kiana Sanajoyan, who is the Master Teacher for the facility. This facility operates on a traditional school year schedule from August to June with an AM/PM half day program. The AM session start 8:00 AM to 11:30 AM; PM session start 1:00 PM to 4:30 PM, Monday through Friday. This facility has 1 classroom. Breakfast, lunches, and snacks are delivered by the headstart kitchen (Schelby) to the classroom.

LPA toured the facility indoors and outdoors. During inspection, there was no daycare children present as this week, teachers are conducting home visits. Teachers are aware that 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.


Assembly Bill 2370, Chapter 676, Statutes of 2018 requires all Child Care Centers (CCCs) that are in buildings constructed before January 1, 2010 to test their drinking water for lead contamination by January 1, 2023 and every 5 years thereafter. This facility is unable to provide evidence of completed water testing. (See 809D for plan of correction). As of December 2022, the facility has been providing Abraham 5 gallon water for the daycare children both indoors and outdoors until testing is completed.

(Continued on LIC809-C).

SUPERVISOR'S NAME: Rene MancinasTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Ka VangTELEPHONE: (559) 410-0327
LICENSING EVALUATOR SIGNATURE:
DATE: 02/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/14/2023
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


Document Has Been Signed on 02/14/2023 12:17 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: MITCHELL HEAD START
FACILITY NUMBER: 243808275

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/14/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.16(a)(1)
Lead Testing
(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above. Per facility Representative Staff 1 (S1), the sink(s) and faucet(s) in the facility have been tested but she did not have proof of the testing which poses a potential health, safety, or personal rights risk to persons in care.
POC Due Date: 03/15/2023
Plan of Correction
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Facility Representative stated they will provide a certified external water sampler conduct the water collection for all outlets used for drinking or food preparation by 03/15/2023. The facility Representative agrees to provide LPA with completed LIC 9275-External Water Sampler Self-Certification Form, Completed LIC 9276-Child Care Center Sampling Checklist and LIC 999 Facility Sketch fully labeled with the location of all water outlets, including outlets that will not be sampled within two weeks of the completed sampling date.
Type B
Section Cited
WD
100700(c)(1)
Written Directives for Lead Testing
(1) For a license issued on or after July 1, 2022, initial testing results shall be received and posted within 180 days of licensure.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above. During the indoor inspection, LPA did not observe licensee posted the initial testing results of the water tested for lead contamination levels. Facility Representative Staff 1 (S1) stated the facility conducted the water for lead testing, but she did not have the result report. S1 had a copy of the parents’ notification so she immediately posted the parents notification of water testing for lead in the facility but not the water tested results as she did not have in the facility which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/15/2023
Plan of Correction
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Facility Representative stated they will post the initial testing results within 180 days of licensure Facility Representative agreed to submit Proof of Correction (POC) to Community Care Licensing (CCL)-Fresno office by 3/15/2023.
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 MancinasTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Ka VangTELEPHONE: (559) 410-0327
LICENSING EVALUATOR SIGNATURE:
DATE: 02/14/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/14/2023
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: MITCHELL HEAD START
FACILITY NUMBER: 243808275
VISIT DATE: 02/14/2023
NARRATIVE
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There is a working fire extinguisher, smoke detector, carbon monoxide detector and adequate heating and ventilation for safety and comfort. 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.

Facility Representative 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 #2 has her current CPR and First Aid, expires on 08/2024 and Staff #3 has her current CPR and First Aid, expires on 01/2024. Staff #1 has current mandated child abuse reporting training completed on 11/26/2022. Staff #2 has current mandated child abuse reporting training completed on 08/10/2021. Staff #3 has current mandated child abuse reporting training completed on 08/10/2022. 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. Facility maintains a ratio of one teacher supervising no more than four children in care.



(Continued on LIC809-C).
SUPERVISOR'S NAME: Rene MancinasTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Ka VangTELEPHONE: (559) 410-0327
LICENSING EVALUATOR SIGNATURE:

DATE: 02/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2023
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
FRESNO-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: MITCHELL HEAD START
FACILITY NUMBER: 243808275
VISIT DATE: 02/14/2023
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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 was discussed, and facility is providing Incidental Medical Services (IMS). LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. 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 Facility Representative 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 are deficiencies 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.

Exit interview conducted and report was reviewed with Facility Representative Kiana Sanjayouyan.
SUPERVISOR'S NAME: Rene MancinasTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Ka VangTELEPHONE: (559) 410-0327
LICENSING EVALUATOR SIGNATURE:

DATE: 02/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2023
LIC809 (FAS) - (06/04)
Page: 4 of 4