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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 503810117
Report Date: 09/24/2020
Date Signed: 09/24/2020 11:40:52 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:PATRICIA KAY BEAVER STATE PRESCHOOLFACILITY NUMBER:
503810117
ADMINISTRATOR:GONZALES, MARYFACILITY TYPE:
850
ADDRESS:4927 CENTRAL AVETELEPHONE:
(209) 556-1730
CITY:CERESSTATE: CAZIP CODE:
95307
CAPACITY:24CENSUS: 0DATE:
09/24/2020
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Mary GonzalesTIME COMPLETED:
12:30 PM
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On 09/24/2020, Licensing Program Analyst (LPA) Juvenal Moctezuma & Claudia Henley conducted an announced prelicensing inspection and met with Site Supervisor, Elena Oraham & Program Director, Mary Gonzales. The center is located in Room #2 on school grounds of Patricia Kay Beaver Elementary School. The licensee is requesting a capacity of 24 Preschool children. This program will operate on a traditional school year on half day programs from 08:00 AM to 11:00 AM & from 12:15 PM to 3:30 PM Monday through Friday. Breakfast and lunch will be provided since the program is only half day. The food will be transported in containers from the cafeteria. The meals will be packaged and sealed. Staff will utilize the staff bathroom located inside the office area. Ill Children will be isolated in the school office and utilize the ill child's bathroom in the office area. The classroom was observed to be clean and free of toxins. The cleaning items will be stored in a high cabinet inside the children's bathroom which are inaccessible. LPA observed that the furniture and equipment appeared to be safe and in good condition. A working carbon monoxide is installed and in working order. Applicant will be administrating medication and it will be stored and locked in a file cabinet.

Room measurements were taken and reviewed with Mary Gonzales. The total inside preschool area measured to an approximate 1,056.63 square feet which will accommodate the requested capacity of 24. There is adequate storage space available for children's belongings. Toys and equipment are age appropriate. There is a total of 1 and 1 hand washing fixture inside of the classroom, and another toilet and hand washing sink located on the elementary school grounds which is down the hall. The one stall in the bathroom has been designated with a sign stating "preschool use only". Staff is reminded that children must be supervised at all times to and from the elementary school bathroom. Licensee has requested a bathroom waiver. There is drinking fountain inside the classroom. Licensee will utilize a water igloo and disposable cups for outside drinking water.

SUPERVISOR'S NAME: Alice JuarezTELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Claudia HenleyTELEPHONE: (559) 341-5776
LICENSING EVALUATOR SIGNATURE:

DATE: 09/24/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2020
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 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: PATRICIA KAY BEAVER STATE PRESCHOOL
FACILITY NUMBER: 503810117
VISIT DATE: 09/24/2020
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 There is drinking fountain inside the classroom.

The approximate outside square footage for the preschool area is 23,768 which will accommodate the requested capacity of 24 Preschool Children. Licensee will share the playground area with the kindergarten children on alternate outside times. Licensee to submit a playground waiver to the department. There is three drinking fountains and a shade structure on the playground area. There was a playground climbing structure which is age appropriate and a sign is posted on the playground structure for ages 2 to 5 years old.

A fire clearance for 24 children was received and granted by the Ceres Fire Department on 8/4/2020.

This facility plans to provide Incidental Medical Services – IMS. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. A 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.

The following items must be completed prior to issuing a license within the next 30 days:

  • A playground waiver will need to be submitted to the department for approval.
  • The playground shade structure needs to be anchored into the ground
  • An Incidental Medical Services Plan needs to be submitted to the department
  • Fingerprint clearance or criminal record clearance transfer request submitted to department to associate fingerprints to the facility.
SUPERVISOR'S NAME: Alice JuarezTELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Claudia HenleyTELEPHONE: (559) 341-5776
LICENSING EVALUATOR SIGNATURE:

DATE: 09/24/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2020
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: PATRICIA KAY BEAVER STATE PRESCHOOL
FACILITY NUMBER: 503810117
VISIT DATE: 09/24/2020
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Pending a final file review and completion of above items, a recommendation will be made to license the above facility for a capacity of 24 preschool children.

The following documents should be posted at the facility:
* PUB 269- Child passenger restraint systems poster 101225(f) Transportation
* Pub 393- Notification of Parents Rights 101218.1(c) Admission Procedures
* License 101160(a) License
* Menus 101227(a)(6) Food Services
* LIC 613A- Personal Rights form 101223(b)(2) Personal Rights
* LIC 610- Disaster Plan 101174(a)
* LIC 9148- Earthquake Preparedness Checklist 101174(b)
* Activity Schedule
* Lead Poisoning brochure

No deficiencies cited during today's visit.
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: Alice JuarezTELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Claudia HenleyTELEPHONE: (559) 341-5776
LICENSING EVALUATOR SIGNATURE:

DATE: 09/24/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2020
LIC809 (FAS) - (06/04)
Page: 3 of 3