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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 500311278
Report Date: 06/13/2019
Date Signed: 06/13/2019 02:57:25 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:SACRED HEART PRESCHOOLFACILITY NUMBER:
500311278
ADMINISTRATOR:CANNELLA, DEBRAFACILITY TYPE:
850
ADDRESS:1250 COOPER AVENUE, SUITE 3TELEPHONE:
(209) 634-8578
CITY:TURLOCKSTATE: CAZIP CODE:
95380
CAPACITY:75CENSUS: 28DATE:
06/13/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Assistant Director - Simone ZipserTIME COMPLETED:
03:15 PM
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An unannounced Annual/Random inspection was conducted today by Licensing Program Analyst (LPA) Luisa Gavoutian. LPA met with Assistant Director Simone Zipser and toured the facility, both indoors and outdoors. There are no bodies of water on site. Firearms/weapons are not allowed or stored on premises. During today’s inspection, LPA observed that while children in Classroom C were playing outside, they were not being accompanied by staff when they had to go back into the classroom to use the restroom or get a drink of water. LPA observed one staff present in the kitchen within the classroom during this time, who was not supervising the children that were going inside. Staff understand that all children are to be under visual supervision at all times. There is a ratio of one teacher supervising no more than 12 children in attendance. During today’s inspection, LPA observed the supplies closet in Classroom C was not locked and contained various cleaning supplies located both on the floor and on the shelves. Assistant Director stated that the closet is usually kept locked and understands that it shall remain locked during daycare days/hours of operation. No poisons were observed during today’s inspection. All materials and surfaces accessible to children are toxic free. Medications are in a safe place inaccessible to children. All toilets, hand washing, 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. Facility has one or more functioning carbon monoxide detectors that meet statutory requirements.

All kitchen, food prep, and storage areas are clean, free of litter, rubbish, and rodents/vermin. All food is protected from contamination, and contaminated food is discarded immediately. Solid waste storage vessels, including moveable bins, have tight-fitting covers, and are in good repair. Uncontaminated 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.

(Continued on next page, LIC809-C)
SUPERVISOR'S NAME: Alice JuarezTELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Luisa GavoutianTELEPHONE: (559) 341-4725
LICENSING EVALUATOR SIGNATURE:

DATE: 06/13/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2019
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: SACRED HEART PRESCHOOL
FACILITY NUMBER: 500311278
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/13/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/15/2019
Section Cited
HSC
1596.7995(a)(1)
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Immunizations. Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. This requirement was not met as evidenced by:
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Licensee to submit completion of immunizations to CCL office by POC date 07/15/2019.
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Based on records reviewed, out of eight staff records three staff were missing immunization records for all or part of required immunizations as described in LIC809. This poses a potential risk to health, safety, or personal rights of children in care.
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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: Alice JuarezTELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Luisa GavoutianTELEPHONE: (559) 341-4725
LICENSING EVALUATOR SIGNATURE:

DATE: 06/13/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2019
LIC809 (FAS) - (06/04)
Page: 4 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: SACRED HEART PRESCHOOL
FACILITY NUMBER: 500311278
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/13/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/27/2019
Section Cited
CCR
101229(a)(1)
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Responsibility for Providing Care and Supervision. No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation. This requirement was not met as evidenced by:
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Facility will have a documented meeting with staff that discusses proper supervision of children. Facility will send proof of the meeting to CCL by POC date 06/27/2019.
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Based on observation, children were not supervised when going back into the classroom to use the restroom or get a drink of water while the class was outside. This poses a potential risk to the health, safety, or personal rights of children in care.
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Type B
06/13/2019
Section Cited
CCR
101238(g)
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Buildings and Grounds. Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children shall be stored where inaccessible to children. This requirement was not met as evidenced by:
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During today's inspection, Assistant Director stated that the door is usually locked. Assistant Director locked the door and posted a sign on the door to ensure that door remains locked.

Deficiency cleared during today's inspection.
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Based on observation the supply closet in Classroom C was unlocked during today's inspection and contained various bottles of cleaning supplies. This poses a potential risk to the health, safety, or personal rights of children in care.
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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: Alice JuarezTELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Luisa GavoutianTELEPHONE: (559) 341-4725
LICENSING EVALUATOR SIGNATURE:

DATE: 06/13/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2019
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: SACRED HEART PRESCHOOL
FACILITY NUMBER: 500311278
VISIT DATE: 06/13/2019
NARRATIVE
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Playground equipment is in good condition, free of sharp, loose, or pointed parts.
Outdoor activity space surface is maintained in a safe condition and is free of hazards. Areas around high climbing equipment, swings, and slides have cushioning material in the form of rubber bark to absorb falls.

Community Care Licensing shall notify a licensee to immediately terminate the employment of, or to remove/bar any person with specified convictions or for other reasons. The licensee shall comply with the notice. Before working or volunteering in a licensed child care facility, all individuals subject to a criminal record review have a clearance or exemption and have been associated to the facility. Staff records contain appropriate documentation of education credits. LPA reviewed eight staff records and found that Staff 1 was missing record of immunizations for measles, pertussis, and influenza; Staff 2 was missing record of immunization for measles, and Staff 3 was missing immunization record for influenza. At least one person trained in CPR and Pediatric first-aid is present when children are at the facility or at off-site activities. The person who signs the child in/out, is responsible for the child, uses his/her full legal signature and records the time of day. Child's admission agreement is available for review.

Hours of operation are Monday – Friday, 7:30am – 6:00pm.

Required CCL forms are posted on parent's board.

This facility provides Incidental Medical Services – IMS. There are no children currently enrolled requiring IMS. Licensee to submit IMS plan to CCL within 30 days. 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.

Per Chapter 1, Division 12, Title 22 of the California Code of Regulations, the following deficiencies are found: (see LIC809-D). Exit interview was conducted with Assistant Director Simone Zipser. Licensee was provided a copy of appeal rights.

THIS REPORT SHALL BE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.


LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS.
SUPERVISOR'S NAME: Alice JuarezTELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Luisa GavoutianTELEPHONE: (559) 341-4725
LICENSING EVALUATOR SIGNATURE:

DATE: 06/13/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2019
LIC809 (FAS) - (06/04)
Page: 2 of 4