503600402-9-26-2019-04-CC-TMAZ-BGDTTD-20190926150036

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 503600402
Report Date: 09/26/2019
Date Signed: 09/26/2019 03:00:45 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:	ST. STANISLAUS PRESCHOOL		FACILITY NUMBER:	503600402
ADMINISTRATOR:	LOPEZ, BIANCA		FACILITY TYPE:	850
ADDRESS:	1416 MAZE BLVD		TELEPHONE:	(209) 524-9036
CITY:	MODESTO	STATE: CA	ZIP CODE:	95351
CAPACITY:	51	CENSUS: 27	DATE:	09/26/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	10:45 AM
MET WITH:	Sonia Ruiz Lopez		TIME COMPLETED:	03:15 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 this date, Licensing Program Analyst (LPA) Theresa Marquez conducted an unannounced Annual inspection and met with Substitute Director Sonia Ruiz Lopez. The Preschool consist of 2 class rooms; Preschool and PK. LPA Marquez toured the facilities, both indoors and outdoors. 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. This is an AM half day and full day program which operates on a traditional school year schedule. The morning session is 8:00 AM to 12:15 PM and the full day session is 7:30 AM to 5:30 PM Monday through Friday. Required CCL forms are posted on parent's board. Furniture and equipment are in good condition. All materials and surfaces accessible to children are toxic free. All floors are clean and safe. AM/PM snacks are provided. Children may bring their own lunch or purchase a hot lunch from the school cafeteria. All kitchen, food prep, and storage areas are clean, free of litter, rubbish, and rodents/vermin. Menus are posted at least one week in advance, where an authorized representative can view them. All toilets, and hand washing facilities are in safe and sanitary operating conditions. The preschool children have exclusive use of the play yard. Playground equipment is in good condition, free of sharp, loose, or pointed parts. Areas around high climbing equipment, swings, and slides have cushioning material to absorb falls. Uncontaminated drinking water is available both indoors and outdoors. There are no bodies of water on site. Firearms/weapons are not allowed or stored on premises. Facility has one or more functioning carbon monoxide detectors that meet statutory requirements. Continued on LIC809-C

SUPERVISOR'S NAME: Susie Fanning	TELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Theresa Marquez	TELEPHONE: (559) 341-7123
LICENSING EVALUATOR SIGNATURE:	DATE: 09/26/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2019

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: ST. STANISLAUS PRESCHOOL	FACILITY NUMBER: 503600402
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/26/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 10/25/2019 Section Cited	1 2 3 4 5 6 7	TRAINING FOR MANDATED REPORTER (MRT); On or before 3/30/2018, a person who, on 1/1/2018, is a licensed child care provider, administrator, or employee of a licensed child day care facility shall complete the (MRT) provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal MRT every 2 yrs.
	8 9 10 11 12 13 14	following the date on which he or she completed the initial MRT. This requirement was not met as evidence by record review. There is no evidence of Staff completion of the required MRT or renewal MRT. This poses a potential risk to the Health, Safety and Personal Rights of children in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7
	1 2 3 4 5 6 7

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: Susie Fanning	TELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Theresa Marquez	TELEPHONE: (559) 341-7123
LICENSING EVALUATOR SIGNATURE:	DATE: 09/26/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2019

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: ST. STANISLAUS PRESCHOOL	FACILITY NUMBER: 503600402
	VISIT DATE: 09/26/2019

NARRATIVE

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Staff records contain appropriate, documentation of education credits. Before working or volunteering in a licensed child care facility, all individuals subject to a criminal record review have a CA Criminal Record clearance.
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. Child's admission agreement is available for review.

This facility provides Incidental Medical Services (IMS). Medications are stored where inaccessible to children. 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.

The Director is to submit to the Fresno CCL office the following updated licensing forms by October 25, 2019: LIC 500 - Personnel Report; LIC 308 Designation of Administrative Responsibility; LIC 610 Emergency Disaster Plan.

Per Chapter 1, Division 12, Title 22 of the California Code of Regulations, the following deficiency was observed: see the attached LIC809-D. A copy of Licensee’s Appeal Rights was provided to Sonia Ruiz Lopez today.

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: Theresa Marquez	TELEPHONE: (559) 341-7123
LICENSING EVALUATOR SIGNATURE:	DATE: 09/26/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2019

LIC809 (FAS) - (06/04)

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