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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 503604971
Report Date: 10/15/2019
Date Signed: 10/15/2019 12:05:34 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:MAYRIS BADDELL CHILD DEVELOPMENT CENTERFACILITY NUMBER:
503604971
ADMINISTRATOR:SIEGEL, ANNFACILITY TYPE:
850
ADDRESS:641 NORSEMAN DRIVETELEPHONE:
(209) 576-4600
CITY:MODESTOSTATE: CAZIP CODE:
95357
CAPACITY:30CENSUS: 18DATE:
10/15/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Heidi Nunes, Senior DirectorTIME COMPLETED:
12:15 PM
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An unannounced Annual/Random inspection was conducted today by Licensing Program Analysts (LPAs) Angelica Mejia and Diana Martinez. LPAs met with Heidi Nunes, Senior Director, Early Childhood Education, and toured the facility, both indoors and outdoors.

This facility is located on the Johansen High School campus and is housed in a building separate from the main school site. There are no bodies of water on site. Firearms/weapons are not allowed or stored on premises. All children are under supervision, including visual supervision, 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 visit. All materials and surfaces accessible to children are toxic free. All toilets, hand washing, and bathing facilities are in safe and sanitary operating conditions. All floors are clean and safe. Furniture and equipment are in good condition and free of sharp, loose, or pointed parts. All kitchen, food prep, and storage areas are clean and free of litter, rubbish, and pests. Breakfast and lunch are prepared off-site in the high school cafeteria and are delivered to the preschool daily. All food is protected from contamination, and contaminated food is discarded immediately. Solid waste storage vessels, including moveable bins, have tight-fitting covers on and are in good repair. Uncontaminated drinking water is available both indoors and outdoors. Menus are posted at least one week in advance and are visible to authorized representatives. Facility has one or more functioning carbon monoxide detectors that meet statutory requirements. Fire/Disaster drills are conducted monthly and documented. Playground equipment is in good condition and free of sharp, loose, or pointed parts. Outdoor activity space surface is maintained in a safe condition and is free of hazards. Areas around high climbing equipment and slides have wood chips as a cushioning material to absorb falls.
(Continued on LIC809-C)
SUPERVISOR'S NAME: Duane MatsubaraTELEPHONE: (559) 650-7855
LICENSING EVALUATOR NAME: Angelica MejiaTELEPHONE: (559) 341-6126
LICENSING EVALUATOR SIGNATURE:

DATE: 10/15/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2019
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: MAYRIS BADDELL CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 503604971
VISIT DATE: 10/15/2019
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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 this facility, all individuals subject to a criminal record review have a clearance or exemption through Stanislaus County Office of Education as a condition of employment. LPAs reviewed personnel and children’s records. Staff records contain appropriate documentation of education credits. At least one person trained in CPR and Pediatric first-aid is present with an expiration date of 08/2021. 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 is an AM/PM half day program which operates on a traditional school year schedule. The morning session is from 8:00am to 11:00am and the afternoon session is from 12:00pm to 3:00pm, Monday through Friday. Required CCL forms are posted on parent's board.

This facility does not provide Incidental Medical Services (IMS). Licensee is aware that an IMS plan is required to be submitted to Community Care Licensing (CCL) if any of these services are provided. LPA discussed IMS with the Licensee and the following information regarding 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

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 Heidi Nunes.

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: Duane MatsubaraTELEPHONE: (559) 650-7855
LICENSING EVALUATOR NAME: Angelica MejiaTELEPHONE: (559) 341-6126
LICENSING EVALUATOR SIGNATURE:

DATE: 10/15/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2019
LIC809 (FAS) - (06/04)
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