503808972-10-11-2019-04-CC-CBRN-BGUM4Z-20191011091736

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 503808972
Report Date: 10/11/2019
Date Signed: 10/11/2019 09:17:40 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:	LITTLE LIGHTS PRESCHOOL		FACILITY NUMBER:	503808972
ADMINISTRATOR:	MATZKIND, CAROL		FACILITY TYPE:	850
ADDRESS:	1660 ARBOR WAY		TELEPHONE:	(209) 668-2548
CITY:	TURLOCK	STATE: CA	ZIP CODE:	95380
CAPACITY:	45	CENSUS: 37	DATE:	10/11/2019
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	08:00 AM
MET WITH:	Carol Matzkind		TIME COMPLETED:	09:30 AM

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	A case management inspection visit was conducted on this date by Licensing Program Analyst (LPA) Brannon, who met with Director, Carol Matzkind. The center is located at First United Methodist Church. The licensee is Little Lights PS of First United Methodist Church. The licensee is requesting to add the Social Hall as a licensed area for children to utilize as needed. Room measurements taken and reviewed with Carol Matzkind. The total social hall square footage is 2946. Per Carol Matzkind, licensee will utilize the igloo, that is used for the outside play, to provide drinking water to the preschool children while utilizing the social hall. Licensee is aware that a cup dispenser is required for the disposable cups. This helps ensures that the children's drinking is uncontaminated as required. Fire marshal granted the fire clearance with a special condition: Stage doors shall be locked during regular school usage and day care are not allowed to enter kitchen area. Fire marshal approved the overall capacity of 45 preschool children. CONTINUED ON FOLLOWING PAGE

SUPERVISOR'S NAME: Michael Duarte	TELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Cynthia Brannon	TELEPHONE: (559) 341-5155
LICENSING EVALUATOR SIGNATURE:	DATE: 10/11/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2019

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: LITTLE LIGHTS PRESCHOOL	FACILITY NUMBER: 503808972
	VISIT DATE: 10/11/2019

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The following items must be completed prior to issuing a license by:
1. Gates are to be installed in front of the kitchen doors to ensure preschool children do not have access into the kitchen.
2. A carbon monoxide detector was not located in the social hall. Per Carol Matzkind, the fire alarm system has the carbon monoxide detector built into the system. A copy of documentation stating that the carbon monoxide is built into the system or a carbon monoxide detector placed in the social hall is required.

Upon receiving documentation showing the corrections, licensee can utilize the social hall. Per Carol Matzkind, the gates will be a temporary installment until locks are installed on the metal swinging kitchen doors. Licensee will contact the Fresno Community Care Licensing when this is completed, and a LPA will conduct an inspection visit. Per Carol Matzkind, the locks will be placed on the metal kitchen doors within six months.

Per California Code of Regulations Title 22, Division 12, no deficiency cited during today's inspection visit. Exit interview conducted with the director, Carol Matzkind A copy of this report need to be placed in facility file for public review. A Notice of Site Visit was posted on parent board.

The following documents should be posted at the facility:
Ø PUB 269 – child passenger restraint systems poster
Ø PUB 393 – Notification of Parents Rights
Ø License
Ø Menus
Ø LIC 613A – Personal Rights form
Ø LIC 610 – Disaster Plan
Ø LIC 9148 – Earthquake Preparedness Checklist

A COPY OF THIS REPORT IS TO REMAIN IN THE FACILITY FOR PUBLIC REVIEW.
THIS REPORT SHALL BE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
To order forms, etc. visit our website at www.ccld.ca.gov

SUPERVISOR'S NAME: Michael Duarte	TELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Cynthia Brannon	TELEPHONE: (559) 341-5155
LICENSING EVALUATOR SIGNATURE:	DATE: 10/11/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2019

LIC809 (FAS) - (06/04)

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