503601681-2-13-2020-04-CC-RMAS-BLRRPB-20200213121141

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 503601681
Report Date: 02/13/2020
Date Signed: 02/13/2020 12:11:47 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:	WILSON ELEMENTARY		FACILITY NUMBER:	503601681
ADMINISTRATOR:	NUNES, HEIDI		FACILITY TYPE:	850
ADDRESS:	201 WILSON AVE		TELEPHONE:	(209) 576-4827
CITY:	MODESTO	STATE: CA	ZIP CODE:	95351
CAPACITY:	24	CENSUS: 0	DATE:	02/13/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	Laura Schaapman		TIME COMPLETED:	12:20 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 02/13/2020 Licensing Program Analyst (LPA) conducted an unannounced annual inspection. LPA met with Site Supervisor, Laura Schaapman. This is a single classroom facility housed on the Wilson Elementary School Campus. LPA toured the facility, both indoors and outdoors to inspect areas accessible to children in care. There are no bodies of water on site. Firearms/weapons are not allowed or stored on premises. Staff understands all children are to be under supervision, including visual supervision, of a teacher at all times. 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 when stored at the facility are to be stored in areas inaccessible. All floors are clean and safe. Furniture and 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.

Facility has a waiver for restrooms and playground. Restrooms are shared with the elementary school children and children need to leave the classroom to use the restroom. There are two sets of restrooms utilized by the preschool children. Children are escorted and supervised when using these restrooms by the employees. All toilets, hand washing, and bathing facilities are in safe and sanitary operating conditions. The playground area is shared with the elementary school kindergarten class. Facility understands elementary children are not to share playground at the same time as preschool children, in order to avoid commingle of both groups. **WAIVERS ARE POSTED AT FACILITY**

Uncontaminated drinking water is available both indoors and outdoors. Menus are posted at least one week in advance, where an authorized representative can view them. Facility has one or more functioning carbon monoxide detectors that meet statutory requirements.

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 and have been associated to the facility.

(Continued on 809-C)

SUPERVISOR'S NAME: Susie Fanning	TELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Rene Mancinas	TELEPHONE: (559) 341-4524
LICENSING EVALUATOR SIGNATURE:	DATE: 02/13/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2020

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 2

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: WILSON ELEMENTARY	FACILITY NUMBER: 503601681
	VISIT DATE: 02/13/2020

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

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.

HOURS OF OPERATION: School Year Schedule/Monday through Friday: 08:30am to 11:30am. Meals are prepared off site delivered to the classrooms for children consumption.

Required CCL forms are posted in a prominent place and are readily available for parents/public view. LPA informed Director of the Community Care Licensing Division website, which provides access to Provider Information Notices (PINs), Quarterly Updates, Mandated Reporter Training, Safe Sleep information, Lead Poisoning information, forms available for print, and information regarding Department regulations.

LPA informed of required lead testing of drinking water requirement per Assembly Bill 2370 and California Health and Safety Code section 1597.16, which requires licensed child care center facilities to test their water for lead by January 1 2023, and subsequent testing every five years after the date of the first test.

Per Chapter 1, Division 12, Title 22 of the California Code of Regulations no deficiencies are observed today. Notice of Site Visit to be posted for 30 days from today’s inspection. Exit interview was conducted with Site Supervisor, Laura Schaapman.

SUPERVISOR'S NAME: Susie Fanning	TELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Rene Mancinas	TELEPHONE: (559) 341-4524
LICENSING EVALUATOR SIGNATURE:	DATE: 02/13/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2020

LIC809 (FAS) - (06/04)

Page: 2 of 2