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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 500312341
Report Date: 08/19/2021
Date Signed: 08/19/2021 06:38:16 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:TRINITY NURSERY SCHOOLFACILITY NUMBER:
500312341
ADMINISTRATOR:CASSANDRA TORREZFACILITY TYPE:
830
ADDRESS:1600 CARVER RDTELEPHONE:
(209) 578-5625
CITY:MODESTOSTATE: CAZIP CODE:
95350
CAPACITY:24CENSUS: 14DATE:
08/19/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:20 PM
MET WITH:Director, Cassi TorrezTIME COMPLETED:
06:45 PM
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On 08/19/2021, Licensing Program Analysts (LPAs) Stefanie Galvan and Luisa Gavoutian conducted an unannounced Annual Inspection. LPAs met with Director, Cassi Torrez, who accompanied LPAs on a tour of the facility, inside and outside. There are no bodies of water on the premises. Firearms and other weapons are not allowed or stored on the premises of a child care center. Disinfectants, cleaning solutions, and other items that are dangerous to children, are inaccessible to children and will be kept in locked areas out of reach of children at all times. Furniture and equipment are in good condition, free of sharp, loose, or pointed parts. The facility has age-appropriate furniture and equipment including, but not limited to, cribs, cots, or mats. The facility has sufficient infant napping equipment. No baby walkers were observed during today’s inspection. The facility has indoor activity space for infants that is physically separate from space used by preschool child components. The child care center is clean, safe, sanitary, and in good repair at all times to ensure the safety and well-being of children, employees, and visitors. Facility has one or more functioning carbon monoxide detectors that meet statutory requirements. The licensee takes measures to keep the facility free of flies, other insects, and rodents. While in use, infant changing tables are placed within arm's reach of a sink. All medications are centrally stored, maintained with the child's name, are dated, and follow the conditions as prescribed.

Upon arrival, LPAs observed 14 infants present and four staff. Staff records were reviewed and found that only one of the four staff present had completed the required three infant units. LPAs observed one infant asleep on the stomach. The infant's file was reviewed and LPAs observed the LIC 9227 was not updated to indicate that the infant is able to roll over from the front to the back and from back to front. Furthermore, LPAs observed that 15 minute checks on sleeping infants was not being done and documented on infants 12-24 months of age. Director stated that the checks will be done and documented effective immediately.

Continued on 809-C
SUPERVISOR'S NAME: Alice JuarezTELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Stefanie GalvanTELEPHONE: (559) 341-5431
LICENSING EVALUATOR SIGNATURE:

DATE: 08/22/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2021
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 5
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: TRINITY NURSERY SCHOOL
FACILITY NUMBER: 500312341
VISIT DATE: 08/19/2021
NARRATIVE
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The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. LPAs observed sufficient cushioning material in the form of rubber pellets underneath high climbing equipment.

All storage containers for solid waste, including moveable bins, have tight fitting covers that are kept on, and are in good repair. Bottles, dishes, and containers of food brought by the infant's authorized representative are labeled with the infant's name and the current date. Menus are posted at least one week in advance in a place visible by the child's authorized representative, dated, kept on file for 30 days, and are made available upon request.
Capacity as specified on the license is being maintained. Visual supervision requirement of children one-hundred percent of the time was discussed with Director. There is a ratio of one staff supervising no more than four infants in attendance. Prior to working or volunteering in a licensed childcare facility, all individuals subject to criminal record review have obtained a clearance or criminal record exemption. Community Care Licensing (CCL) 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.

The Licensee ensures that personnel records are maintained on the Licensee, administrator, and each employee. The facility ensures that staff being utilized as infant teachers meet the qualification requirements. 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 uses his/her full legal signature and records the time of day. Individual feeding plans for each infant are maintained. The Infant Needs and Services Plan for each infant shall be maintained with napping information, and be updated quarterly.

Hours of operation are Monday – Friday, 7:30am to 5:30pm.

All required CCL forms are posted on parent's board.

Continued on 809-C

SUPERVISOR'S NAME: Alice JuarezTELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Stefanie GalvanTELEPHONE: (559) 341-5431
LICENSING EVALUATOR SIGNATURE:

DATE: 08/19/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2021
LIC809 (FAS) - (06/04)
Page: 2 of 5
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: TRINITY NURSERY SCHOOL
FACILITY NUMBER: 500312341
VISIT DATE: 08/19/2021
NARRATIVE
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This facility provides Incidental Medical Services – IMS. LPAs reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. The following information regarding the Americans with Disabilities Act (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.

LPAs & Director, Cassi Torrez discussed the Community Care Licensing (CCL) website www.ccld.ca.govwhich will provide access to Provider Information Notices (PINs), Quarterly Updates, Mandated Reporter Training, forms, regulations, and other important information. LPAs thoroughly discussed safe sleep practices.

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 Director, Cassi Torrez. Licensee was provided a copy of appeal rights.

This report is to be made available to the public upon request.

Site Visit Notice posted on the parent board and to remain for 30 days.

SUPERVISOR'S NAME: Alice JuarezTELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Stefanie GalvanTELEPHONE: (559) 341-5431
LICENSING EVALUATOR SIGNATURE:

DATE: 08/19/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2021
LIC809 (FAS) - (06/04)
Page: 3 of 5
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: TRINITY NURSERY SCHOOL
FACILITY NUMBER: 500312341
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/19/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/02/2021
Section Cited

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Staff-Infant Ratio (1) An aide may be substituted for a teacher when...(A) There is a fully qualified teacher directly supervising no more than 12 infants. This requirement was not met as evidenced by:
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During observation of infant/toddler areas, there were 14 children present and only one fully-qualified staff supervising 3 aides. This poses a potential risk to the health, safety, or personal rights of children.
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Type B
08/26/2021
Section Cited

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Responsibility for Providing Care and Supervision for Infants (B) Staff shall physically check on sleeping infant(s) every 15 minutes and document the following: 1. Labored breathing. 2. Signs of distress... 3. Infants up to 12 months of age who are sleeping in a position other than on their back.
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This requirement was not met as evidenced by:
Based on observation and interview, 15 minute checks were not being completed and documented for infants 12-24 months of age. This poses a potential risk to the health, safety, or personal rights of children.
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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: Stefanie GalvanTELEPHONE: (559) 341-5431
LICENSING EVALUATOR SIGNATURE:
DATE: 08/19/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/19/2021
LIC809 (FAS) - (06/04)
Page: 5 of 5
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: TRINITY NURSERY SCHOOL
FACILITY NUMBER: 500312341
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/19/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/30/2021
Section Cited

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Responsibility for Providing Care and Supervision for Infants; Infants up to 12 months of age who are sleeping in a position other than on their back. This requirement was not met as evidenced by:
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Based on observation and record review, one infant was observed sleeping on stomach and did not have a completed and updated LIC 9227 on file indicating that infant is able to roll over. This poses a potential risk to the health, safety, or personal rights of children.
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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: Stefanie GalvanTELEPHONE: (559) 341-5431
LICENSING EVALUATOR SIGNATURE:
DATE: 08/19/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/19/2021
LIC809 (FAS) - (06/04)
Page: 4 of 5