500318266-2-26-2020-04-CC-RGUZ-BM6R59-20200226114245

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 500318266
Report Date: 02/26/2020
Date Signed: 02/26/2020 11:42:52 AM

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:	WESTPORT STATE PRESCHOOL		FACILITY NUMBER:	500318266
ADMINISTRATOR:	COUGHRAN, CHARLENE		FACILITY TYPE:	850
ADDRESS:	5218 SO CARPENTER RD		TELEPHONE:	(209) 538-0148
CITY:	MODESTO	STATE: CA	ZIP CODE:	95351
CAPACITY:	24	CENSUS: 19	DATE:	02/26/2020
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Christine Cardoso		TIME COMPLETED:	12:00 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 02/26/2020 an unannounced required one year inspection was conducted today by Licensing Program Analyst (LPA) Robert Gutierrez. LPA met with Teacher Dana Rubio and Assistant Preschool Director, Christine Cardoso. LPA toured the facility, both indoors and outdoors. There are no swimming pools or other bodies of water on the premises. Firearms and ammunition are not permitted on the premises. All children are under supervision, including visual supervision, of a teacher at all times. There is a ratio of one teacher supervising no more than 12 children in attendance. Disinfectants, cleaning solutions and other dangerous items shall be inaccessible to children. 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 other equipment are in good condition, free of sharp, loose, or pointed parts. Solid waste storage vessels, including moveable bins, have tight-fitting covers on, 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. There is working carbon monoxide detector, adequate heating, lighting and ventilation for safety and comfort. Areas around high climbing equipment and slides have cushioning material to absorb falls. 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. Before working or volunteering in a licensed child care facility, all individuals subject to a criminal record review have a clearance or exemption. Staff fingerprint through Ceres Unified School District as a condition of employment. Staff records contain appropriate, documentation of education credits and Mandated reporter training. An emergency fire/disaster drill has been completed within the last 6 months. 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 their full legal signature and records the time of day. LPA reviewed a sample of children’s file and observed files were complete. Licensee maintains admission agreement and forms as required. Facility license, personal rights, menus, child passenger restraint system poster, daily activity schedule, emergency disaster plan, earthquake preparedness checklist, and parent’s right poster are posted on the parent board. This is an AM/PM half day program which operates from August- May. The morning session is 8:00am to 11:15am and the afternoon session is 12:00pm to 3:15pm, Monday through Friday. Continued on 809 -C

SUPERVISOR'S NAME: Susie Fanning	TELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Robert Gutierrez	TELEPHONE: 559-243-4588
LICENSING EVALUATOR SIGNATURE:	DATE: 02/26/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2020

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
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: WESTPORT STATE PRESCHOOL	FACILITY NUMBER: 500318266
	VISIT DATE: 02/26/2020

NARRATIVE

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This facility provides Incidental Medical Services (IMS). LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. The following information regarding Americans with Disability Act (ADA) was provided: US Department of Justice toll free ADA Information line at (800) 514-0301(voice) and (800) 514-0383 (TDD) and website link
https://www.ada.gov/childqanda.htm for Commonly Asked Questions about Child Care Centers and the ADA.

LPA and Licensee discussed Mandated Reporter Training, Lead Poisoning Facts, Forms and Regulations.

Per Chapter 1, Division 12, Title 22 of the California Code of Regulations no deficiencies are observed today. Site Visit Notice posted on the parent board. Exit interview was conducted with Christine Cardoso.

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: Susie Fanning	TELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Robert Gutierrez	TELEPHONE: 559-243-4588
LICENSING EVALUATOR SIGNATURE:	DATE: 02/26/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2020

LIC809 (FAS) - (06/04)

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