540405560-8-16-2019-04-CC-TMAZ-BF4SR8-20190816140554

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 540405560
Report Date: 08/15/2019
Date Signed: 08/16/2019 02:05:59 PM

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:	GREENHOUSE MONTESSORI SCHOOL		FACILITY NUMBER:	540405560
ADMINISTRATOR:	HOFFMAN ANNE;CLANCY, NINA		FACILITY TYPE:	840
ADDRESS:	4143 DANS LANE		TELEPHONE:	(559) 625-8385
CITY:	VISALIA	STATE: CA	ZIP CODE:	93277
CAPACITY:	42	CENSUS: 6	DATE:	08/15/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	02:15 PM
MET WITH:	Nina Clancy		TIME COMPLETED:	04:15 PM

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	Licensing Program Analyst (LPA) Theresa Marquez conducted an unannounced annual inspection and met with Licensee Nina Clancy. LPA Marquez toured the facility, both indoors and outdoors. All children are under supervision, including visual supervision, of a teacher at all times. Required CCL forms are posted on the parent's board. Hours of operation Monday through Friday 7:30AM to 5:30PM. Furniture and equipment are in good condition. All materials and surfaces accessible to children are toxic free. All floors are clean and safe. The facility provides an AM and PM snack. Snack menus are posted at least one week in advance, where an authorized representative can view them. All toilets, hand washing, and bathing facilities are in safe and sanitary operating conditions. Medications are stored in the staff room and inaccessible to children. No poisons were observed during today’s inspection. In combination programs, outdoor activity space provided for school-age children is physically separate from space provided for preschool care children. Playground equipment is in good condition. Uncontaminated drinking water is available both indoors and outdoors. There are no bodies of water on site. Firearms/weapons are not allowed or stored on premises. Facility has one or more functioning carbon monoxide detectors that meet statutory requirements. Staff records contain appropriate, documentation of education credits. Licensee provided proof of required immunizations (Pertussis/Measles/Influenza) and/or written declaration declining flu shot for staff. At least one person trained in CPR and Pediatric first-aid is present when children are at the facility or at off-site activities.

SUPERVISOR'S NAME: Susie Fanning	TELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Theresa Marquez	TELEPHONE: (559) 341-7123
LICENSING EVALUATOR SIGNATURE:	DATE: 08/15/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2019

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 2

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: GREENHOUSE MONTESSORI SCHOOL	FACILITY NUMBER: 540405560
	VISIT DATE: 08/15/2019

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
26
27
28
29
30
31
32

The sign in/sign out sheet was reviewed and observed to be in compliance. Child's admission agreement is available for review. 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.

This facility provides Incidental Medical Services (IMS). LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.

Licensee is to provide the following updated licensing forms to the Fresno CCL office by September 10, 2019: LIC 500 - Personnel Report; LIC 308 Designation of Administrative Responsibility; LIC 610 Emergency Disaster Plan.
Per Chapter 1, Division 12, Title 22 of the California Code of Regulations no deficiencies are observed today.

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: Susie Fanning	TELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Theresa Marquez	TELEPHONE: (559) 341-7123
LICENSING EVALUATOR SIGNATURE:	DATE: 08/15/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2019

LIC809 (FAS) - (06/04)

Page: 2 of 2