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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 540404986
Report Date: 12/16/2021
Date Signed: 12/17/2021 11:04:47 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:ST. PAUL'S SCHOOL PRE-SCHOOL ENRICHMENT PROGRAMFACILITY NUMBER:
540404986
ADMINISTRATOR:TIFFANY CONNORSFACILITY TYPE:
850
ADDRESS:6101 W. GOSHEN AVENUETELEPHONE:
(559) 739-1619
CITY:VISALIASTATE: CAZIP CODE:
93291
CAPACITY:50CENSUS: 45DATE:
12/16/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Amy Sanchez- Director TIME COMPLETED:
04:30 PM
NARRATIVE
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On 12/16/21 Licensing Program Analyst (LPA) Jessika Thompson conducted an unannounced Annual Required Inspection for the preschool license. LPA met with Director Amy Sanchez and toured the facility indoors and outdoors.

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. LPA observed a hose line than runs horizontally near the western perimeter gate. The hose line is raised several inches from the ground which could pose a tripping hazard to children in care while at play. All toilets and hand-washing facilities are in safe and sanitary operating condition. Floors in the facility are clean and safe. Breakfast, lunch, and snacks are provided by parents or authorized representatives. 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. All materials and surfaces accessible to children are toxic free. The facility is free of flies, insects and rodents. Director Sanchez was unable to provide proof of presence of a functional carbon monoxide detector. Prior to working or volunteering in a licensed childcare facility, all individuals subject to a criminal record review have received a criminal record clearance or exemption. No individuals excluded by the Department are allowed to be present. 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 off site activities. The name of the childcare center director or fully-qualified teacher(s) designated to act in the director’s absence has been reported to the Department. All children are under supervision, including visual supervision, of a teacher at all times. Facility maintains a ratio of one teacher supervising no more than 12 children in care (continued on LIC809-C).

SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Jessika ThompsonTELEPHONE: 559-341-4622
LICENSING EVALUATOR SIGNATURE:

DATE: 12/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2021
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 6
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: ST. PAUL'S SCHOOL PRE-SCHOOL ENRICHMENT PROGRAM
FACILITY NUMBER: 540404986
VISIT DATE: 12/16/2021
NARRATIVE
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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; however, children's files were missing Admissions Agreements. LPA reviewed a sample of staff files and observed files were complete with documentation of meeting educational qualification requirements; however, some staff files were missing immunization records, and other required employment records.

Director Sanchez 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.

Incidental Medical Services (IMS) policy was discussed. 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.

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

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

This report shall be made available to the public upon request. A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with Director Amy Sanchez.

SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Jessika ThompsonTELEPHONE: 559-341-4622
LICENSING EVALUATOR SIGNATURE:

DATE: 12/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2021
LIC809 (FAS) - (06/04)
Page: 2 of 6
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: ST. PAUL'S SCHOOL PRE-SCHOOL ENRICHMENT PROGRAM
FACILITY NUMBER: 540404986
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/16/2021

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.954
Licensure Requirements
Every licensed child day care center shall have one or more carbon monoxide detectors in the facility that meet the standards established in Chapter 8 (commencing with Section 13260) of Part 2 of Division 12. The department shall account for the presence of these detectors during inspections.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above as staff were unable to provide proof of the presence of a functioning carbon monoxide detector, on site, during today's inspection. This poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/16/2022
Plan of Correction
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Director Sanchez stated the facility will acquire and install a functioning carbon monoxide detector inside the preschool program. Director Sanchez to provide proof of installation to the Fresno Regional Office by 1/16/22.
Type B
Section Cited
CCR
101238.2(d)(2)
Outdoor Activity Space
(d) The surface of the outdoor activity space shall be maintained: (2) Free of hazards including, but not limited to, holes, broken glass and other debris, and dry grasses that pose a fire hazard.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above, as today LPA observed a raised, loose hose line in the outdoor play area (see LIC809 for further details). This poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/16/2022
Plan of Correction
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Director stated she will cover the hose line with soil and ensure that it is secure and no long elevated from the ground. Director stated she will submit photos to the Fresno Regional Office, by 1/16/22, reflecting this correction.
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: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Jessika ThompsonTELEPHONE: 559-341-4622
LICENSING EVALUATOR SIGNATURE:
DATE: 12/16/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/16/2021
LIC809 (FAS) - (06/04)
Page: 3 of 6
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: ST. PAUL'S SCHOOL PRE-SCHOOL ENRICHMENT PROGRAM
FACILITY NUMBER: 540404986
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/16/2021

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101219
The licensee and the child's authorized representative shall jointly complete a current individual written admission agreement for the child. This documentation shall be maintained at the child care center and shall be available for review.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in 10 out of 10 children's files reviewed which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/16/2022
Plan of Correction
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Director Sanchez stated she will ensure all children enrolled have an Admissions Agreement on file at the facility going foward. Director stated she will submit completed and signed Admission's Agreements for Children 1-10 to the Fresno Regional Office by 1/16/22.
Type B
Section Cited
HSC
1596.7995(a)(1)
Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record reviews, the licensee did not comply with the section cited above in 3 out of 6 staff files reviewed which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/16/2022
Plan of Correction
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Director Sanchez stated she will send proof of the required immunizations for Staff #1, Staff #4, & Staff #6 to the Fresno Community Care Licensing office by 1/16/22.
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: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Jessika ThompsonTELEPHONE: 559-341-4622
LICENSING EVALUATOR SIGNATURE:
DATE: 12/16/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/16/2021
LIC809 (FAS) - (06/04)
Page: 4 of 6
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: ST. PAUL'S SCHOOL PRE-SCHOOL ENRICHMENT PROGRAM
FACILITY NUMBER: 540404986
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/16/2021

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101216(g)(2)
(2) Each person specified in (g) above shall have a health-screening report signed by the person performing the screening.


This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on the licensee did not comply with the section cited above in 3 out of 6 staff files reviewed which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/16/2022
Plan of Correction
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Director Sanchez stated she will submit completed Health Screening Reports for Staff #1, Staff #4, and Staff #6 to the Fresno Regional Office by 1/16/22
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Jessika ThompsonTELEPHONE: 559-341-4622
LICENSING EVALUATOR SIGNATURE:
DATE: 12/16/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/16/2021
LIC809 (FAS) - (06/04)
Page: 6 of 6