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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543808374
Report Date: 09/26/2019
Date Signed: 09/26/2019 02:47:26 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:KRAYOLA KORNER SCHOOL READINESSFACILITY NUMBER:
543808374
ADMINISTRATOR:JOHNSON, SHARONFACILITY TYPE:
850
ADDRESS:420 N. E STREETTELEPHONE:
(559) 782-1234
CITY:PORTERVILLESTATE: CAZIP CODE:
93257
CAPACITY:30CENSUS: 19DATE:
09/26/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Sheena Rosqueta, TeacherTIME COMPLETED:
03:00 PM
NARRATIVE
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LPA Pete Espinoza conducted an unannounced annual/random visit. LPA met with Sheena Rosqueta, Teacher, who provided a tour of facility, inside and outside, as shown on the facility sketch. There are no bodies of water, firearms and/or ammunition on the premises. Disinfectants, hazardous items and medications are inaccessible to children. Storage area for poisons is locked and inaccessible to children. Furniture, equipment and materials are sufficient, age appropriate, in good repair and toxic free. The playground equipment and outdoor activity space is maintained and in good condition, free of hazards with adequate cushioning material. Children's toilets and hand washing facilities are sanitary and in good operating condition. Rooms and floors are safe and clean. Food preparation area is clean and free of rodent and other vermin. Contaminated food is discarded immediately, when applicable. Storage containers for solid waste are in good repair with tight-fitting covers. Sanitary drinking water is available both indoors and outdoors. The licensee is taking measures to keep the facility free of insects, rodents, etc. All individuals subject to a criminal record review have a clearance or exemption and have been associated to the facility as indicated on LIS 555 – Facility Roster. Qualified staff designated to act in the Director’s absence has been reported accordingly. Sign In/Sign Out sheets have a full legal signature and time of day. 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 medical and consent for emergency medical.

Licensee provided proof of required immunization (Pertussis/Measles/Influenza) and written declaration declining flu shot AND Certificate of Completion required Mandated Reporter Training for all staff.

Operating hours are Mon-Fri 8:00 AM – 4:00 PM
SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Peter EspinozaTELEPHONE: 661-644-8231
LICENSING EVALUATOR SIGNATURE:

DATE: 09/26/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2019
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 4
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: KRAYOLA KORNER SCHOOL READINESS
FACILITY NUMBER: 543808374
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/26/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/28/2019
Section Cited

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Personnel Records- A health screening as specified in Section 101216(g). This requirement is not met as evidenced by interviews records review conducted during today’s inspection.
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A review of staff records indicates there is no Health Screening Report for staff. This poses a potential risk to the health, safety or personal rights of children in care.
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Type B
10/28/2019
Section Cited

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Child's Medical Assessments - Prior to, or within 30 calendar days following the enrollment of a child, the licensee shall obtain a written medical assessment of the child. This requirement is not met as evidenced by interviews records review conducted during today’s inspection.
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A review of children's records indicates there is no Health Screening Report for several children. This poses a potential risk to the health, safety or personal rights of children in care.
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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: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Peter EspinozaTELEPHONE: 661-644-8231
LICENSING EVALUATOR SIGNATURE:
DATE: 09/26/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/26/2019
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: KRAYOLA KORNER SCHOOL READINESS
FACILITY NUMBER: 543808374
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/26/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/28/2019
Section Cited

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Personnel Requirements - At least one staff member who is trained in pediatric cardiopulmonary resuscitation and pediatric first aid pursuant to Health and Safety Code Section 1596.866 shall be present when children are at the child care center.
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This requirement is not met as evidenced by records review conducted during today’s inspection. A review of Staff records indicates no Certification for CPR in staff files.
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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: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Peter EspinozaTELEPHONE: 661-644-8231
LICENSING EVALUATOR SIGNATURE:
DATE: 09/26/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/26/2019
LIC809 (FAS) - (06/04)
Page: 4 of 4
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: KRAYOLA KORNER SCHOOL READINESS
FACILITY NUMBER: 543808374
VISIT DATE: 09/26/2019
NARRATIVE
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Incidental Medical Services (IMS) policy was discussed. Incidental Medical Services (IMS) are not 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. 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) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm
Please update LIC 500, LIC 610, LIC 308, and Facility Sketch and send to Fresno Regional Office.

NO DEFICIENCIES OBSERVED IN THE AREAS INSPECTED DURING TODAY’S VISIT.

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: Peter EspinozaTELEPHONE: 661-644-8231
LICENSING EVALUATOR SIGNATURE:

DATE: 09/26/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2019
LIC809 (FAS) - (06/04)
Page: 2 of 4