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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543801302
Report Date: 08/27/2020
Date Signed: 08/27/2020 12:38:10 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:IVANHOE ELEMENTARY SCHOOL PRESCHOOLFACILITY NUMBER:
543801302
ADMINISTRATOR:CARDOZA, DEBORAHFACILITY TYPE:
850
ADDRESS:16030 AVENUE 332TELEPHONE:
(559) 730-7849
CITY:IVANHOESTATE: CAZIP CODE:
93235
CAPACITY:24CENSUS: 0DATE:
08/27/2020
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Administrator, Amy SullivanTIME COMPLETED:
01:00 PM
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On 8/27/2020, Licensing Program Analysts (LPAs) Jose Penate and Juvenal Moctezuma conducted an unannounced case management inspection at the facility and met with Administrator, Amy Sullivan. The purpose of the inspection was to observe the new playground area and that the measurements will meet regulation standards prior to installation. LPA's observed the new playground/climbing structure that will be installed via email and structure measurements are to standards and the structure is age appropriate for preschool children. LPA's advised administrator that all new shade anchors/poles that are installed in the playground shall have foam cushion around to prevent any injury to child. LPA's did a walk through and advised Amy to fix the chain link fence all around since some of the chain link fence is broken off or not attached to the bottom and is loose. LPA's advised Amy to shave all the thread bolts to a recommended size of 3/4 threads around the fence. A fence could be installed if the pavement will not be fixed behind the First Five classroom. LPA's reminded Amy to fill in any holes through out the yard to prevent any tripping hazards and cover any water spigots or water lines/pipes outside classroom since their sticking out and are a tripping hazard.

Per Chapter 3, Division 12, Title 22 of the California Code of Regulations no deficiencies were observed today.

Exit interview was conducted with Administrator, Amy Sullivan. Administrator was provided a copy of the Facility Evaluation Report (LIC 809) and the Notice of Site Visit form (LIC 9213). The LIC 809 is required to remain in the facility for public review and the LIC 9213 is required to be posted for 30 days.
SUPERVISOR'S NAME: Duane MatsubaraTELEPHONE: (559)650-7855
LICENSING EVALUATOR NAME: Jose PenateTELEPHONE: (559) 341-5860
LICENSING EVALUATOR SIGNATURE:

DATE: 08/27/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2020
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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