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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 540405710
Report Date: 02/18/2020
Date Signed: 02/18/2020 01:43:06 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:FAIRVIEW VILLAGE CHILD DEVELOPMENT CENTERFACILITY NUMBER:
540405710
ADMINISTRATOR:CHRISTINA HANGERFACILITY TYPE:
850
ADDRESS:2645 N. CONYER STREETTELEPHONE:
(559) 627-2296
CITY:VISALIASTATE: CAZIP CODE:
93291
CAPACITY:44CENSUS: 31DATE:
02/18/2020
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Christina Hanger - Director TIME COMPLETED:
02:00 PM
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Licensing Program Analyst (LPA) Jessika Thompson conducted an unannounced annual/random inspection. LPA met with Director Christina Hanger. A tour of the facility as shown on the facility sketch was performed. This facility operates Monday through Friday from 7:45 AM to 4:00 PM. Breakfast and lunch is prepared at another site and transported to this facility. Meals and/or snacks are served in the classroom. There are no bodies of water. Firearms and ammunition are not on the premises. Furniture, equipment and materials are sufficient, age appropriate, in good repair and toxic free. Rooms and floors are safe and clean. The licensee is taking measures to keep the facility free of insects, rodents, etc. Criminal record clearance records are completed as condition for employment and maintained by the Tulare County Office of Education. Conditions, limitations and capacity specified on license are in compliance. First Aid/CPR reviewed and in compliance. Teacher/child ratios are maintained, and adequate supervision is provided during visit. Menus are posted. A sample of children's and staff’s records reviewed. Children’s records include required information including; Name, address and telephone number of child’s authorized representative and relatives and/or others who can assume responsibility in the event authorized representative cannot be reached. Staff records contain required documentation of the educational background, training, proof of immunization, and Child Abuse Mandated Reporter certification. Lead safety was discussed, and Director Hanger understands that lead safety information must also be provided to parents and/or authorized representatives of children in care. Provider Information Notices were discussed, and Director Hanger is subscribed to receive updates via email. Director Hanger is aware that forms and updated information may be obtained on Community Care Licensing website, (www.ccld.ca.gov). Fire and disaster drills are conducted at least once every six months and documented with the date and time. Earthquake safety was discussed and form LIC-9148, Earthquake Preparedness Checklist, is posted on parent’s board.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records (Continued on LIC809-C)
SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Jessika ThompsonTELEPHONE: 559-341-4622
LICENSING EVALUATOR SIGNATURE:

DATE: 02/18/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/18/2020
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: FAIRVIEW VILLAGE CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 540405710
VISIT DATE: 02/18/2020
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Per California Code of Regulations, Title 22, Division 12, no deficiencies were observed today.

LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS
SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Jessika ThompsonTELEPHONE: 559-341-4622
LICENSING EVALUATOR SIGNATURE:

DATE: 02/18/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/18/2020
LIC809 (FAS) - (06/04)
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