503605107-5-30-2023-04-CC-JYAZ-CSBRHL-20230530130232

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 503605107
Report Date: 05/30/2023
Date Signed: 05/30/2023 01:02:47 PM

Document Has Been Signed on 05/30/2023 01:02 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, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME:	EMANUEL LUTHERAN DAY CARE		FACILITY NUMBER:	503605107
ADMINISTRATOR:	LAURA MARQUEZ		FACILITY TYPE:	830
ADDRESS:	324 COLLEGE AVE.		TELEPHONE:	(209) 523-4531
CITY:	MODESTO	STATE: CA	ZIP CODE:	95350
CAPACITY:	20	CENSUS: 10	DATE:	05/30/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Elena Castillo Wilson		TIME COMPLETED:	01:10 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 05/30/2023, Licensing Program Analysts (LPAs) Jeovanna Yanez and Yesenia Fierro, conducted an unannounced Annual Required Inspection for the infant license. LPAs met with Assistant Director, Elena Castillo Wilson, and toured the facility indoors and outdoors. The facility is housed on the Emanuel Lutheran Church premises. Days and hours of operation are Monday to Friday, 6:30 AM – 6:00 PM year round. There is no swimming pool or other bodies of water on the premises. There are no firearms or ammunition allowed or stored on the premises. Disinfectants, cleaning solutions, medication and other hazardous items are made inaccessible. No poisons were observed during the inspection. Furniture and equipment are in good condition, free of sharp, loose or pointed parts. Playground equipment is in safe condition, free of sharp, loose or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. All toilets and handwashing facilities are in safe and sanitary operating condition. Floors in the facility are clean and safe. The facility provides AM and PM snack, parents provide meals for children. Menus are posted at least one week in advance where an authorized representative can view them. All food is protected against contamination and any contaminated food is discarded immediately. Solid waste storage containers have tight-fitting covers and are in good repair. Drinking water is available both indoors and outdoors. Areas around high climbing equipment, swings and slides have cushioning material to absorb falls. The facility is free of flies, insects and rodents. There is a working carbon monoxide detector. This facility has a toddler component, which is physically separate from the infant area. A tour of the infant and toddler areas were conducted. The facility has sufficient age appropriate furniture, and equipment including cribs, cots or mats, changing tables and feeding chairs. There is indoor and outdoor activity space for infants that is physically separate. Each crib, mat or cot is occupied by only one infant at time and cribs are kept free from all loose articles including blankets and pillows and there are no objects hanging above or attached to the crib. (CONTINUED ON 809-C)

SUPERVISOR'S NAME: Rene Mancinas	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Jeovanna Yanez	TELEPHONE: (559) 341-5629
LICENSING EVALUATOR SIGNATURE:	DATE: 05/30/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/30/2023

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
FRESNO-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: EMANUEL LUTHERAN DAY CARE	FACILITY NUMBER: 503605107
	VISIT DATE: 05/30/2023

NARRATIVE

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Infants are not swaddled while in care. Staff physically checks on sleeping infants every fifteen minutes and documents any signs of distress which includes but is not limited to flushed skin color, increase in body temperature, restlessness and labored breathing. Documentation for infants up to 12 months includes sleeping position if it is other than on their back. Individual Infant Sleeping Plan is completed and in file for each infant up to 12 months of age. Infants up to 12 months of age are placed on their backs for sleeping. Staff-infant ratio requirements are being met while infants are sleeping.

Facility representative was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated. Upon notification from the Department, the licensee will comply and act immediately to terminate the employment of, remove from the facility or bar from entering the facility for any person it is deemed necessary while the Department considers granting or denying an exemption. Capacity and limitations as specified on the license are being maintained. At least one person trained in CPR and Pediatric First Aid is present when children are at the facility or at offsite activities. The name of the child care center director or fully-qualified teacher(s) designated to act in the director’s absence has been reported to the Department. The person who signs the child in/out of the facility shall use their full legal signature and record the time of day. 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 four infants in care. LPA reviewed a sample of children’s files and observed files were complete with contact information for authorized representative and or relatives or others who can assume responsibility for the child, medical assessment, individual feeding plan, and Infant Needs and Services Plan. LPA was unable to review staff files for required documentation. LPA advised Assistant Director that files should be readily available for review during the inspection. LPA will return and complete file reviews on another date. .

LPA discussed the safe sleep regulations with facility representative and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed facility representative of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment. (CONTINUED ON 809-C)

SUPERVISOR'S NAME: Rene Mancinas	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Jeovanna Yanez	TELEPHONE: (559) 341-5629
LICENSING EVALUATOR SIGNATURE:	DATE: 05/30/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/30/2023

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
FRESNO-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: EMANUEL LUTHERAN DAY CARE	FACILITY NUMBER: 503605107
	VISIT DATE: 05/30/2023

NARRATIVE

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Assembly Bill 2370, Chapter 676, Statutes of 2018 requires all Child Care Centers (CCCs) that are located in buildings constructed before January 1, 2010 to test their drinking water for lead contamination by January 1, 2023 and every 5 years thereafter. This facility was not able to provide evidence of completed water testing. (See 809-D). Per Assistant Director, the facility has been providing alternative potable water for the child care center children, staff and visitors both indoors and outdoors until testing is completed. The facility is pending response from a water sampler to confirm a date for lead testing.

Incidental Medical Services (IMS) policy was discussed. Currently, There are no children enrolled on an IMS plan. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. 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.

LPA and Licensee discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINs), Quarterly Updates, COVID-19 Information and Resources, Mandated Reporter Training, Safe Sleep in Child Care, Lead Poisoning Facts, Forms and Regulations.
To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, , the following deficiency is being cited: (see next page, 809-D). Licensee was provided a copy of their appeal rights.

Exit interview conducted and report was reviewed with the facility representative Elena Castillo Wilson. A notice of site visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Rene Mancinas	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Jeovanna Yanez	TELEPHONE: (559) 341-5629
LICENSING EVALUATOR SIGNATURE:	DATE: 05/30/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/30/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 05/30/2023 01:02 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: EMANUEL LUTHERAN DAY CARE	FACILITY NUMBER: 503605107
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/30/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1597.16(a)(1)

(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on interview and record review, the licensee did not comply with the section cited above. Licensee was not able to provide evidence of lead water testing as required by AB2370, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 06/30/2023
	Plan of Correction
1 2 3 4	Assistant Director agrees to submit the following documentation for proof of lead testing by POC due date: LIC 9275-External Water Sampler Self-Certification Form, LIC 9276-Child Care Center Sampling Checklist and LIC 999 Facility Sketch fully labeled with the location of all water outlets, including outlets that will not be sampled.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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: Rene Mancinas	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Jeovanna Yanez	TELEPHONE: (559) 341-5629
LICENSING EVALUATOR SIGNATURE:	DATE: 05/30/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/30/2023

LIC809 (FAS) - (06/04)

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