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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 503608405
Report Date: 10/24/2019
Date Signed: 10/29/2019 10:55:10 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:TENDER HEARTS CHILDCARE CENTERFACILITY NUMBER:
503608405
ADMINISTRATOR:GALVAN, CONNIEFACILITY TYPE:
830
ADDRESS:2118 WOODLAND AVE.TELEPHONE:
(209) 550-5930
CITY:MODESTOSTATE: CAZIP CODE:
95358
CAPACITY:20CENSUS: 12DATE:
10/24/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Connie GalvanTIME COMPLETED:
03:45 PM
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An unannounced Annual/Random inspection was conducted today by Licensing Program Analysts (LPAs) Angelica Mejia and Kathy Pacheco. LPAs met with Director Connie Galvan and toured the facility, both indoors and outdoors. There are no bodies of water on site. Firearms/weapons are not allowed or stored on premises. 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 floors are clean and safe. There is sufficient infant napping equipment that is physically separated from the infant activity area. Infant indoor and outdoor activity space is separate from other components of the facility. Furniture and equipment are in good condition and free of sharp, loose, or pointed parts. Bottles, dishes, and containers of food brought by the infant's authorized representative are labeled with the infant's name and the current date. While in use, infant changing tables are placed within arm's reach of a sink. All kitchen, food prep, and storage areas are clean and free of litter, rubbish, and pests. All food is protected from contamination, and contaminated food is discarded immediately. All food and beverages capable of rapid spoiling are stored in covered containers at 45°(F) or less. 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. 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, swings, 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: 10/24/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/24/2019
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 3
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: TENDER HEARTS CHILDCARE CENTER
FACILITY NUMBER: 503608405
VISIT DATE: 10/24/2019
NARRATIVE
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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 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. Licensee could not provide proof of CPR and Pediatric first-aid training for at least one person present at the facility. A review of personnel and children’s records was conducted. Staff records contain appropriate documentation of health screening, education credits and infant qualifications that include educational background, training and/or experience. Children’s records include required medical assessment, consent for emergency medical treatment and an Infant Needs and Services Plan that includes an individual feeding plan. 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. Required CCL forms are posted on parent's board. Hours/days of operation are: Monday – Friday, 7:00AM to 6:00PM.

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, the following deficiencies are found: (see LIC809-D). Licensee was provided a copy of appeal rights.

Site Visit Notice posted on the parent board. Exit interview was conducted with Connie Galvan.

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: 10/24/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/24/2019
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: TENDER HEARTS CHILDCARE CENTER
FACILITY NUMBER: 503608405
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/24/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/25/2019
Section Cited

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Responsibility for Providing Care and Supervision for Infants Each infant shall be constantly supervised and under direct visual observation and supervision by a staff person at all times. Under no circumstances shall ANY infant be left unattended.
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This requirement was not met as evidenced by observation. LPAs observed an infant asleep in a crib and no staff present in the infant sleeping area to observe the infant. One teacher was in the infant activity area with three other infants. This poses a potential health, safety, or personal rights risk to the children in care.
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Type B
11/25/2019
Section Cited

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Personnel Requirements At least one staff member who is trained in pediatric cardiopulmonary resuscitation and pediatric first aid pursuant to Health and Safety Code Section 1596.866 shall be present when children are at the child care center or offsite for center activities.
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This requirement was not met as evidenced by records review. Licensee could not provide proof of current CPR and Pediatric first-aid training for at least one person present at the facility. This poses a potential health, safety, or personal rights risk to the children in care.
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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: Duane MatsubaraTELEPHONE: (559) 650-7855
LICENSING EVALUATOR NAME: Angelica MejiaTELEPHONE: (559) 341-6126
LICENSING EVALUATOR SIGNATURE:
DATE: 10/24/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/24/2019
LIC809 (FAS) - (06/04)
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