500305696-5-30-2023-04-CC-JYAZ-CSBTTZ-20230530150133

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 500305696
Report Date: 05/30/2023
Date Signed: 05/30/2023 03:01:38 PM

Document Has Been Signed on 05/30/2023 03:01 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:	GRACE LUTHERAN SCHOOL		FACILITY NUMBER:	500305696
ADMINISTRATOR:	STELLE, CINDY		FACILITY TYPE:	850
ADDRESS:	617 W.ORANGEBURG AVE		TELEPHONE:	(209) 522-6393
CITY:	MODESTO	STATE: CA	ZIP CODE:	95350
CAPACITY:	90	CENSUS: 0	DATE:	05/30/2023
TYPE OF VISIT:	Required - 1 Year	ANNOUNCED	TIME BEGAN:	01:15 PM
MET WITH:	Cindy Steele		TIME COMPLETED:	03:15 PM

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On 05/30/2023, Licensing Program Analysts (LPAs) Jeovanna Yanez and Yesenia Fierro, conducted an unannounced Annual Required Inspection for the preschool license. LPAs met with Director,Cindy Steele, and toured the facility indoors and outdoors. The facility is housed on the Grace Lutheran Church premises, and Rooms 6, 7, 8, 13, 14, 22, and the gymnasium were inspected as they are still used for care. Days and hours of operation are Monday to Friday, 6:30 AM – 6:00 PM, year round.

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. No poisons were observed during the inspection.

Furniture and equipment are in good condition, free of sharp, loose or pointed parts. Playground equipment is in safe condition, free of sharp, loose or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. All toilets and handwashing facilities are in safe and sanitary operating condition. Floors in the facility are clean and safe. The facility provides breakfast and PM snack, parents provide meals for children. All kitchen, food preparation and storage areas are clean, free of litter/rubbish and free of rodents/vermin. All food is protected against contamination and any contaminated food is discarded immediately. Solid waste storage containers have tight-fitting covers and are in good repair. Menus are posted at least one week in advance where an authorized representative can view them. Drinking water is available both indoors and outdoors. Areas around high climbing equipment, swings and slides have cushioning material to absorb falls. The facility is free of flies, insects and rodents. Facility has one or more functioning carbon monoxide detectors that meet statutory requirements.

Facility representative was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing 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, the 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. (CONTINUED ON 809-C)

SUPERVISOR'S NAME: Rene Mancinas	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Jeovanna Yanez	TELEPHONE: (559) 341-5629
LICENSING EVALUATOR SIGNATURE:	DATE: 05/30/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/30/2023

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
FRESNO-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: GRACE LUTHERAN SCHOOL	FACILITY NUMBER: 500305696
	VISIT DATE: 05/30/2023

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At least one person trained in CPR and Pediatric First Aid is present when children are at the facility or at offsite activities. 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 12 children in care. LPA reviewed a sample of children’s files and observed files were complete with contact information for authorized representative/relatives/others who can assume responsibility for the child and medical assessment. LPA reviewed a sample of staff files and observed files were complete with documentation of meeting qualification requirements, immunization's, and required personnel forms.

Assembly Bill 2370, Chapter 676, Statutes of 2018 requires all Child Care Centers (CCCs) that are located in buildings constructed before January 1, 2010 to test their drinking water for lead contamination by January 1, 2023 and every 5 years thereafter. Director provided evidence of completed water testing. Sampling was completed on 01/16/2023. Lab testing results indicated one outlet had a lead exceedance, facility has already removed the affected outlet. All required documents have been submitted to the department.

This facility provides Incidental Medical Services – IMS. Currently, there are no children enrolled who need medication administer, nor did the facility have any medications. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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

LPA and Licensee 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/inspection-process.

Per Title 22, Division 12, Chapter 1 of the California Code of Regulations no deficiencies are being cited today.

Exit interview conducted and report was reviewed with facility representative, Cindy Steele. This report shall be made available to the public upon request. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISOR'S NAME: Rene Mancinas	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Jeovanna Yanez	TELEPHONE: (559) 341-5629
LICENSING EVALUATOR SIGNATURE:	DATE: 05/30/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/30/2023

LIC809 (FAS) - (06/04)

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