543801735-1-16-2020-04-CC-DDMZ-BKW2V9-20200116164335

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 543801735
Report Date: 01/16/2020
Date Signed: 01/16/2020 04:43:40 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:	GOLDEN VALLEY PRESCHOOL		FACILITY NUMBER:	543801735
ADMINISTRATOR:	CALVERO, MELISSA		FACILITY TYPE:	850
ADDRESS:	12623 AVENUE 416		TELEPHONE:	(559) 528-6949
CITY:	OROSI	STATE: CA	ZIP CODE:	93647
CAPACITY:	48	CENSUS: 43	DATE:	01/16/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Vidala Gallegos		TIME COMPLETED:	12:40 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	Annual random inspection conducted this date by Licensing Program Analyst (LPA) Diana Martinez. Met with Preschool Teacher Vidala Gallegos and toured the facility. Preschool classrooms 412 and 413 are used for child care and are located in a portable on the Golden Valley Elementary School grounds. This facility operates a morning and afternoon class during the traditional school year. Days and hours are Monday through Friday from 8:00 AM to 11:00 AM and 12:15 PM to 3:15 PM. No bodies of water present. Firearms/weapons are not allowed or stored on premises. All children present receive direct visual supervision at all times. There is a ratio of one teacher supervising no more than 12 children in attendance. Facility is operating within the approved licensed capacity at this inspection. All disinfectants, cleaning solutions, toxic, poisonous items, and medications are inaccessible to children. All toilets, hand washing, and bathing facilities are in safe and sanitary condition. All floors are clean and safe. Furniture and equipment are in good condition, free of sharp, loose or pointed parts. Lunch is prepped and served in the school cafeteria and children are escorted by staff to the cafeteria. Uncontaminated drinking water is available both indoors and out. Menus are posted at least one week in advance where an authorized representative can view them. Menus shall be dated and kept on file for 30 days and be available for review upon request. Facility has at least one functioning carbon monoxide detector that meets statutory requirements. Playground equipment is in good condition, free of sharp, loose, or pointed parts. Outdoor activity space surface is maintained in safe condition and free of hazards. There is a large shade sail cover above play structure. Large sandbox is covered when not in use. Areas under/around high climbing equipment and slides have sufficient cushioning material to absorb falls. Licensee does not exceed the conditions, limitations, and capacity specified on the license. Before working or volunteering in a licensed child care facility, all individuals subject to a criminal record review have a clearance or exemption through Cutler-Orosi Unified School District. There are no excluded individuals present at this center. Licensee is aware that upon notice from the Department, any excluded individual must be immediately removed from the center. Staff records contain appropriate documentation of education credits. At least one person trained in Pediatric CPR/First Aid with the expiration (See next page)

SUPERVISOR'S NAME: Michael Duarte	TELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Diana D Martinez	TELEPHONE: (559) 341-4670
LICENSING EVALUATOR SIGNATURE:	DATE: 01/16/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2020

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: GOLDEN VALLEY PRESCHOOL	FACILITY NUMBER: 543801735
	VISIT DATE: 01/16/2020

NARRATIVE

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date of 10/2021, is present when children are at the facility or at off-site activities. The responsible person who signs the child in/out uses their full legal signature and records the time of day. Child's admission agreement is available for review.

Incidental Medical Services (IMS) are currently being provided. Licensee is aware that an IMS plan is required to be submitted to the licensing office if they provide any of these services. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. 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

Preschool Teacher Vidala Gallegos provided updated copies of LIC 500 (Personnel Report). LPA provided a copy of Lead Poisoning Facts brochure and provided with PIN 19-04-CCP for further information.

Per California Code of Regulations, Title 22, Division 12, Chapter 1, in the areas evaluated no deficiency was cited during today's visit.

Exit interview conducted with Preschool Teacher Vidala Gallegos and a copy of this report was provided and discussed. A Notice of Site Visit Form (LIC 9213) was posted on parent's board and must remain posted for 30 days.

SUPERVISOR'S NAME: Michael Duarte	TELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Diana D Martinez	TELEPHONE: (559) 341-4670
LICENSING EVALUATOR SIGNATURE:	DATE: 01/16/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2020

LIC809 (FAS) - (06/04)

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