243810167-9-7-2021-04-CC-JMOA-C6N28L-20210907171032

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 243810167
Report Date: 09/03/2021
Date Signed: 09/07/2021 05:10:37 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:	SAN LUIS EARLY HEAD START		FACILITY NUMBER:	243810167
ADMINISTRATOR:	MENDOZA, MISTY		FACILITY TYPE:	830
ADDRESS:	129 7TH STREET		TELEPHONE:	(209) 827-5691
CITY:	LOS BANOS	STATE: CA	ZIP CODE:	93635
CAPACITY:	8	CENSUS: 0	DATE:	09/03/2021
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Isabel Abundez		TIME COMPLETED:	10:30 AM

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On 09/03/2021, Licensing Program Analysts (LPAs) Juvenal Moctezuma & Cynthia Brannon conducted an announced prelicensing inspection and met with Education Coordinator, Isabel Abundez. LPAs explained the reason of the inspection and a tour of the center was conducted both inside and outside. The center is located on 129 7th Street in Los Banos, CA. The applicant is requesting an Infant license with a capacity of 4 Infants & 4 toddlers, including up to 4 crib babies. This program will operate year round from 7:00 AM to 5:30 PM Monday through Friday. Both programs will operate in classroom #1. The classroom is divided in half. One side will be for toddlers and one for infants.

Isabel stated that food gets provided by the center - breakfast, lunch, and one snack. Food gets brought over from their centralized kitchen - Westside Headstart and prepped in the classroom. There is a microwave in the classroom that can be used in case food needs to be warmed up and a refrigerator for storage. Isabel stated that the center is also responsible to provide the children with formula, wipes, & diapers so parents don't need to bring their child anything.

Isabel stated that there is no hot running water or knives/sharp utensils in the classroom. The medication will be stored in a high medication box next to the door. Staff will utilize the bathroom located in between classroom #1 & preschool Classroom #2. The staff office is also located in between both classrooms. Ill children will be isolated in the staff office and will use the staff bathroom when ill. There is a washer and dryer in the staff office. LPA observed both the infant and toddler classroom area to be clean and free of toxins. All the cleaning items and toxins are kept in the laundry room. There are a few cleaning items underneath the kitchen sink in each side of the classroom. The bottom cabinets have latches so children don't have access to them.

LPAs observed that the classroom had age appropriate toys. LPA observed that the furniture and equipment inside the classroom appeared to be safe and in good condition. There is at least one working carbon monoxide in the center.

Report Continued Onto LIC 809-C

SUPERVISOR'S NAME: Michael Duarte	TELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Juvenal Moctezuma	TELEPHONE: (559) 580-0275
LICENSING EVALUATOR SIGNATURE:	DATE: 09/03/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2021

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: SAN LUIS EARLY HEAD START	FACILITY NUMBER: 243810167
	VISIT DATE: 09/03/2021

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Isabel will add a partition/divider in the infant side so the toddlers will be able to have access to the bathrooms. LPA observed a changing table in the infant area within arms reach of a sink. There is another changing table on the hallway for the toddlers right outside the children's bathroom. Staff are made aware that the sink will not be used for food preparation. The infant sleeping area is gated off with a see through partition. LPA observed 4 cribs. Isabel stated that the center will wash the bedding/sheets everyday or whenever necessary. Isabel stated that Staff are doing wellness checks & temperature checks every morning during drop off & pick up for for children and staff.

Room measurements were taken and reviewed with Isabel. The total inside Infant area measured to an approximate 194 square feet which will accommodate 4 infants. The total inside Toddler area measured to an approximate 281 square feet which will accommodate 4 toddlers. The center is providing potty training. Infants have their own sippy cups for water which are used both indoor and out. There are also water jugs with disposable cups both indoor and out for the toddlers

The approximate outside square footage for the Infant area is 1,739 square feet which will accommodate 4 Infants at a time. The approximate outside square footage for the toddler area is 2,750 which will accommodate 4 toddlers. Both areas are separate and gated off. There are age appropriate toys on each side with a shade structure that covers both play areas. There is a shed for toy storage, grass, and bike path. LPAs reminded Isabel to provide adequate supervision at all times.

A fire clearance was received by the Los Banos Fire Department. An amended Fire Clearance will be sent out to meet the newly capacity since the preschool capacity has dropped by infants/toddlers occupying this classroom.

This facility plans to provide Incidental Medical Services – IMS. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. A 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

Report Continued Onto LIC 809-C

SUPERVISOR'S NAME: Michael Duarte	TELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Juvenal Moctezuma	TELEPHONE: (559) 580-0275
LICENSING EVALUATOR SIGNATURE:	DATE: 09/03/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2021

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: SAN LUIS EARLY HEAD START	FACILITY NUMBER: 243810167
	VISIT DATE: 09/03/2021

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The following items must be completed prior to issuing a license by 09/17/2021.
Inside Day-care:
· Add divider in infant area.
· Shave or cover all the threads bolts to a recommended size of 3/4 around the fence.

Pending a final file review and completion of above items, a recommendation will be made to license the above facility with an infant license of 9 children. 4 Infants & 4 Toddlers.

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)
* Activity Schedule
* Lead Poisoning brochure
* Shaken Baby brochure
* Safe Sleep Brochure

No deficiencies cited during today's visit.

A COPY OF THIS REPORT IS TO REMAIN IN THE FACILITY FOR PUBLIC REVIEW.
THIS REPORT SHALL BE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
To order forms, etc. visit our website at www.ccld.ca.gov

SUPERVISOR'S NAME: Michael Duarte	TELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Juvenal Moctezuma	TELEPHONE: (559) 580-0275
LICENSING EVALUATOR SIGNATURE:	DATE: 09/03/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2021

LIC809 (FAS) - (06/04)

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