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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 243810167
Report Date: 04/14/2022
Date Signed: 04/14/2022 12:20:59 PM


Document Has Been Signed on 04/14/2022 12:20 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
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710



FACILITY NAME:SAN LUIS EARLY HEAD STARTFACILITY NUMBER:
243810167
ADMINISTRATOR:MENDOZA, MISTYFACILITY TYPE:
830
ADDRESS:129 7TH STREETTELEPHONE:
(209) 827-5691
CITY:LOS BANOSSTATE: CAZIP CODE:
93635
CAPACITY:8CENSUS: 0DATE:
04/14/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Misty MendozaTIME COMPLETED:
12:45 PM
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On April 14, 2022, Licensing Program Analyst (LPA) Brannon and Licensing Program Manager (LPM) Moctezuma met with Site Supervisor, Misty Mendoza. Licensee is requesting a capacity of 4 infants with 4 crib babies and 4 toddlers in the toddler option.

During today's inspection, LPA took photographs of the infant and toddler rooms' set up. LPA discussed with site supervisor that all future changes to the rooms furniture are to meet Title 22 regulations. During today's inspection, LPAs observed that a divider was added in the infant area. Dividers were observed to differentiate the crib area and toddler area. Per site supervisor, the bathroom procedure for children in the toddler option is for staff to walk the children to the restroom or changing table. There is a walkway for the toddlers and staff to use when utilizing the children's restroom. Parents will park in the back parking lot and walk their children to their respective doors. The children's cubbies are next to their respective door leading into the classroom.

LPA and LPM observed that the thread bolts were not shaved or covered as requested in the September 9, 2021 inspection.

ยท Shave or cover all the threads bolts to a recommended size of 3/4 around the fence. Some were completed but not all.

LPA will conducted another unannounced inspection to ensure all requirements are met before the infant license can be issued.

Pending a final file review and completion of above item, a recommendation will be made to license the above facility with an infant license of 8 children: 4 Infants & 4 Toddlers.

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 DuarteTELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Cynthia BrannonTELEPHONE: (559) 388-3635
LICENSING EVALUATOR SIGNATURE:
DATE: 04/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/14/2022
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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