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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543801061
Report Date: 03/13/2023
Date Signed: 03/13/2023 02:07:31 PM


Document Has Been Signed on 03/13/2023 02:07 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710



FACILITY NAME:SAINT ANNE'S PRESCHOOLFACILITY NUMBER:
543801061
ADMINISTRATOR:LOPEZ, SANDRAFACILITY TYPE:
850
ADDRESS:331 NORTH F STREETTELEPHONE:
(559) 781-8614
CITY:PORTERVILLESTATE: CAZIP CODE:
93257
CAPACITY:40CENSUS: 20DATE:
03/13/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:45 AM
MET WITH:Sandra Lopez- Director TIME COMPLETED:
02:20 PM
NARRATIVE
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On 3/13/2023 Licensing Program Analyst (LPA) Jessika Thompson conducted an unannounced Annual Required Inspection for the preschool license. LPA met with Director Sandra Lopez, 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. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. All toilets and hand washing facilities are in safe and sanitary operating condition. Floors in the facility are clean and safe. All kitchen, food preparation and storage areas are clean, free of litter/rubbish and free of rodents/vermin. All foods/beverages capable of rapid spoiling are stored in covered containers at 45 degrees F or less. Solid waste storage containers have tight-fitting covers and are in good repair. 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. Facility has one or more functioning carbon monoxide detectors that meet statutory requirements. 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 (see next page, LIC809C).

SUPERVISOR'S NAME: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Jessika ThompsonTELEPHONE: (559) 341-4622
LICENSING EVALUATOR SIGNATURE:
DATE: 03/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/13/2023
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 8


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: SAINT ANNE'S PRESCHOOL
FACILITY NUMBER: 543801061
VISIT DATE: 03/13/2023
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, 6 of 6 files reviewed was missing form LIC613A- Personal Rights in Child Care Facilities. LPA reviewed a sample of staff files and found 3 of 4 of files to be incomplete. Menus are posted at least one week in advance where an authorized representative can view them. Director Lopez 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).

Assembly Bill 2370, Chapter 676, Statutes of 2018 requires all Child Care Centers (CCCs) that are located in buildings constructed before January 1, 2010 to test their drinking water for lead contamination by January 1, 2023 and every 5 years thereafter. This facility is unable to provide evidence of completed water testing.

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 re being cited: (see next page, 809 D). Licensee was provided a copy of their appeal rights. 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 Lopez.

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.

SUPERVISOR'S NAME: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Jessika ThompsonTELEPHONE: (559) 341-4622
LICENSING EVALUATOR SIGNATURE:

DATE: 03/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2023
LIC809 (FAS) - (06/04)
Page: 2 of 8
Document Has Been Signed on 03/13/2023 02:07 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710


FACILITY NAME: SAINT ANNE'S PRESCHOOL
FACILITY NUMBER: 543801061

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/13/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.16(a)(1)
Lead Testing
(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test.

This requirement is not met as evidenced by:
Deficient Practice Statement
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This requirement was not met as evidenced by interview with Director Lopez indicating that the required drinking water testing has not been completed. This poses a potential threat to the health, safety, or personal rights of children in care.
POC Due Date: 04/13/2023
Plan of Correction
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Director Lopez states they will have a certified external water sampler conduct the water collection for all outlets used for drinking or food preparation by 4/13/2023. The facility agrees to provide LPA with completed LIC 9275-External Water Sampler Self-Certification Form, Completed LIC 9276-Child Care Center Sampling Checklist and LIC 999 Facility Sketch fully labeled with the location of all water outlets, including outlets that will not be sampled within two weeks of the completed sampling date.
Type B
Section Cited
CCR
101216.1(b)(1)
Teacher Qualifications and Duties
(b) Prior to employment, a teacher shall meet the requirements of (b)(1) or (b)(2) below: (1) A teacher shall have completed, with passing grades, at least six postsecondary semester or equivalent quarter units of the education requirement specified in (c)(1) below; or shall have obtained a Child Development Assistant Permit issued by the California Commission on Teacher Credentialing.

This requirement is not met as evidenced by:
Deficient Practice Statement
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This requirement was not met, as during records review, LPA found that Staff #1's file did not contain proof of the required educational credits. This poses a potential risk to the health, safety, or personal rights of children in care.
POC Due Date: 04/13/2023
Plan of Correction
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Director stated she will submit proof of required educational requirements for Staff #1 by 4/13/2023.
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: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Jessika ThompsonTELEPHONE: (559) 341-4622
LICENSING EVALUATOR SIGNATURE:
DATE: 03/13/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/13/2023
LIC809 (FAS) - (06/04)
Page: 3 of 8


Document Has Been Signed on 03/13/2023 02:07 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710


FACILITY NAME: SAINT ANNE'S PRESCHOOL
FACILITY NUMBER: 543801061

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/13/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101223(b)(1)
Personal Rights
(1) The center shall give each authorized representative a copy of the Personal Rights form (LIC 613A [9/96]).

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 6 out of 6 children's files reviewed which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/13/2023
Plan of Correction
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Director Lopez stated that she will ensure that going forward, each authorized representative receives a copy of form LIC613A. Director Lopez stated that she will provide proof of LIC613A forms on file for Child#1-Child#6 to the Fresno Community Care Licensing Office by 4/13/23.
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: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Jessika ThompsonTELEPHONE: (559) 341-4622
LICENSING EVALUATOR SIGNATURE:
DATE: 03/13/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/13/2023
LIC809 (FAS) - (06/04)
Page: 4 of 8