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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 515405496
Report Date: 06/19/2019
Date Signed: 06/26/2019 11:36:26 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME:FUSION PRESCHOOL ACADEMY IIFACILITY NUMBER:
515405496
ADMINISTRATOR:EVERETT, KELLIFACILITY TYPE:
850
ADDRESS:1191 LIVE OAK BLVD.TELEPHONE:
(530) 674-7595
CITY:YUBA CITYSTATE: CAZIP CODE:
95991
CAPACITY:54CENSUS: 30DATE:
06/19/2019
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
04:00 PM
MET WITH:Micheyl Walker, Director of OperationsTIME COMPLETED:
06:05 PM
NARRATIVE
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LPA's Laura Chavez and Sandy Husband conducted a case management inspection to the facility. Upon arrival into the parking lot of the facility at 11:55am, LPA's observed C#1, approximately 150 feet away from staff in the farthest corner of the outdoor play area behind a tree and climbing structure out of the line of site of S#1 and S#2. LPA's observed both staff members with their backs turned away from C#1 for approximately 3 - 5 minutes. Additionally, staff did not look up from serving lunch to scan the outdoor play area, therefore not providing visual supervision to other children in care as well. Once LPA's entered the outdoor play yard a third staff member (S#3) was observed at the other end of the play area with her back turned from the children in care. During today's inspection the facility was toured inside and outside. At 12:15pm, LPA Chavez observed Staff #4 caring for four infants inside the preschool building. Staff #4 stated that the infants have been temporarily moved into the preschool building due to a flea infestation in the infant facility. At 12:25pm, LPA Chavez observed a diaper pail full of soiled diapers and/or pull-ups in the preschool bathroom without a tight fitting lid. At 1:00pm LPA's observed an inadequate amount of cushioning material and bare areas around the three climbing structures in the outdoor play area. Director of Operations stated that cushioning material will be added after flea infestation is eliminated to prevent cross contamination. This report, as well as the American Academy of Pediatrics Guide to Safe Sleep Practices, were reviewed and discussed with Director Kelli Everett. All licensing reports are public information and must be made available upon request for at least three years.

Notice of Site Visit shall be posted for 30 days from today's visit.

The following Type A and B violations of the California Code of Regulations, Title 22; Division 12, were observed: see LIC 809D. Appeal Rights were provided.

Reports citing Type A violations are to be provided to parents/guardians of children currently in enrolled and to parents/guardians of children newly enrolled at the facility during the next 12 months. Parents/guardians must sign Form LIC9224 to be kept in each child's file.

SUPERVISOR'S NAME: Megan AvilesTELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Laura ChavezTELEPHONE: (530) 895-5914
LICENSING EVALUATOR SIGNATURE:

DATE: 06/19/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2019
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, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME: FUSION PRESCHOOL ACADEMY II
FACILITY NUMBER: 515405496
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/19/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/19/2019
Section Cited
HSC
101212
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Reporting Requirements: The facility failed to notify the Department of infants temporarily moved into the preschool building due to a flea infestation in the infant facility.

This requirement was not met as evidenced by: the facility failing to report of infants being moved into the preschool building.
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The Facility Director agrees to provide a written statement of how the facility will ensure reporting requirements.

The plan of correction shall be submitted to CCLD on or before 7/19/2019.
Type B
07/19/2019
Section Cited
HSC
101239(f)(1)
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Fixtures, Furniture, Equipment and Supplies. All storage containers for solid waste, including moveable bins, shall have tight-fitting covers that are kept on, be in good repair, and shall be leak-proof and rodent-proof. This requirement was not met as evidenced by:
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During today's inspection Micheyl Walker, Director of Operations placed the lid back on the diaper pail.

CORRECTION MADE DURING TODAY'S INSPECTION.
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based on the diaper pail observed full of soiled diapers and/or pull-ups in the preschool bathroom without a tight fitting lid.
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Director of Operations agrees to speak with staff on the importance of keeping tight fitting lid(s) on diaper pail(s).
Type B
07/19/2019
Section Cited
HSC
101238.2(e)
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Outdoor Activity Space: Areas around & under high climbing equipment, swings, slides & other similar equipment shall be cushioned with material that absorbs falls.This requirement was not met as evidenced by: inadequate amount of cushioning material around climbing structures in the outdoor play area.
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The Director agrees to provide proof of sufficient cushioning material added under climbing structures in order to meet regulations to CCLD by 7/19/2019. Director also agrees that children in care will not be allowed to use climbing structures until sufficient cushioning is provided.
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: Megan AvilesTELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Laura ChavezTELEPHONE: (530) 895-5914
LICENSING EVALUATOR SIGNATURE:

DATE: 06/19/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2019
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, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME: FUSION PRESCHOOL ACADEMY II
FACILITY NUMBER: 515405496
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/19/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/20/2019
Section Cited
HSC
101229
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Responsibility for Providing Care and Supervision: No child(ren) shall be left without the supervision of a teacher at any time. Supervision shall include visual observation. This requirement was not met as evidenced by: Staff failed to ensure visual supervision of C#1 who was visually unsupervised for approximately 3-5 minutes
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The Director agrees to provide a written plan of correction on how the facility will ensure visual supervison of children in care.

The plan of correction shall be submitted to CCLD on or before 6/20/2019.
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and was approximately 150 feet away in the opposite corner of the outdoor play area from staff.

This presents an immediate risk to 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: Megan AvilesTELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Laura ChavezTELEPHONE: (530) 895-5914
LICENSING EVALUATOR SIGNATURE:

DATE: 06/19/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2019
LIC809 (FAS) - (06/04)
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