<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 500313180
Report Date: 04/01/2025
Date Signed: 04/01/2025 04:27:26 PM

Document Has Been Signed on 04/01/2025 04:27 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 RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:KEYES STATE PRESCHOOLFACILITY NUMBER:
500313180
ADMINISTRATOR/
DIRECTOR:		MATTHEW MURRYFACILITY TYPE:
850
ADDRESS:5680 7TH STREETTELEPHONE:
(209) 667-1660
CITY:KEYESSTATE: CAZIP CODE:
95328
CAPACITY: 20TOTAL ENROLLED CHILDREN: 20CENSUS: 13DATE:
04/01/2025
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:00 PM
MET WITH:Site Supervisor Tatiana RivasTIME VISIT/
INSPECTION COMPLETED:
04:45 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 04/01/2025, Licensing Program Analyst (LPA) Aurelio Mendoza conducted an unannounced Required - 3 Year Inspection for the preschool license. LPA met with Site Supervisor Tatiana Rivas and toured the facility indoors and outdoors. The program operates on a traditional school year schedule, offering morning and afternoon half-day sessions from 7:50 a.m. to 10:50 a.m. and 11:50 a.m. to 2:50 p.m., Monday through Friday.

All poisons, cleaning solutions, medications, and hazardous materials are stored securely and were not observed in accessible areas. No bodies of water, firearms, or ammunition are present on-site. LPA reviewed new pool safety requirements under AB 2866, effective 01/01/2025, and referenced PIN 25-01 CCP issued on 01/06/2025.

Furniture and playground equipment were observed to be in good condition, free of hazards. The outdoor area has proper cushioning materials around high-climbing equipment, swings, and slides. Toilets, handwashing stations, and flooring were clean and well-maintained. Functional carbon monoxide detectors were present, and waste containers had tight-fitting lids.

Drinking water was available indoors and outdoors through personal water bottles, bottled water, and disposable cups. Meals, including breakfast and lunch, are provided by the school cafeteria and delivered to the preschool classroom. Menus are posted at least one week in advance for parental review.

The facility remains within its licensed capacity and maintains appropriate staff-child ratios. At least one staff member trained in CPR and Pediatric First Aid was present during the inspection. LPA verified that the child care center director or a fully qualified teacher designated to act in the director’s absence was reported to the Department. (Continued on LIC809-C)

Cynthia BrannonTELEPHONE: (559) 650-7884
Aurelio MendozaTELEPHONE: (559) 815-8119
DATE: 04/01/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/01/2025
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
California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
Page: 2 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: KEYES STATE PRESCHOOL
FACILITY NUMBER: 500313180
VISIT DATE: 04/01/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
A sample review of children's files confirmed that records contained emergency contact details and medical assessments. Staff files were reviewed and found to be complete, including health screenings, immunization records for influenza, pertussis, and measles, and documentation of completed mandated reporter training. Influenza decline statements are on file for staff who opted out.

LPA discussed reporting requirements outlined in Title 22, Section 101212, and provided information on accessing resources, regulations, forms, and Provider Information Notices (PINs) at www.ccld.ca.gov.

A Technical Advisory (TA) was issued today regarding items observed in the outdoor playground area. LPA noted multiple holes in the ground directly outside the preschool exit near two benches, posing a potential tripping hazard. Additionally, the fence adjacent to this area requires maintenance to prevent children from coming into contact with deteriorating sections and to ensure the perimeter remains secure. This issue was identified as a first-tier concern, requiring prompt attention. The facility has been directed to complete repairs by 07/01/2025 and provide confirmation via email to LPA Aurelio Mendoza upon completion.

LPA discussed criminal record clearances, emphasizing that all adults 18 years and older must obtain a criminal record clearance or exemption before working at the facility, as required by Health and Safety Code (HSC) 1596.871. Failure to comply may result in daily civil penalties.

LPA also reviewed lead testing requirements under Assembly Bill (AB) 2370, confirming that the facility has complied with PIN 21-21.1-CCP. Additional information on water testing for lead contamination can be found at www.cdss.ca.gov/inforesources/child-care-licensing/water-testing-information.

Regarding Incidental Medical Services (IMS), LPA discussed the proper storage of medications and the importance of accurate record-keeping, referencing PIN 22-02-CCP.

Lastly, LPA provided information on ADA compliance, including resources for ensuring accessibility in child care settings. The US Department of Justice (USDOJ) ADA Information Line is available at (800) 514-0301 (voice) or (800) 514-0383 (TTY). Further guidance on child care and ADA requirements can be accessed at https://www.ada.gov/resources/child-care-centers/.

An exit interview was conducted, and the report was reviewed with Site Supervisor Tatiana Rivas. Appeal Rights were provided.

Per Title 22, Division 12, of the California Code of Regulations, no deficiencies were cited.

This report shall be made available to the public upon request. LIC 9213 - Notice of Site Visit was provided and must be posted for 30 days. (End of Report)

SUPERVISOR'S NAME: Cynthia BrannonTELEPHONE: (559) 650-7884
LICENSING EVALUATOR NAME: Aurelio MendozaTELEPHONE: (559) 815-8119
LICENSING EVALUATOR SIGNATURE:

DATE: 04/01/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/01/2025
LIC809 (FAS) - (06/04)
Page: 4 of 4