543808691-1-22-2020-04-CC-RMAS-BL3P4A-20200122095848

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 543808691
Report Date: 01/22/2020
Date Signed: 01/22/2020 09:58:59 AM

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:	ALPAUGH STATE PS/ALPAUGH U.S.D.		FACILITY NUMBER:	543808691
ADMINISTRATOR:	HUDSON, ROBERT M.		FACILITY TYPE:	850
ADDRESS:	5313 ROAD 39		TELEPHONE:	(559) 949-8305
CITY:	ALPAUGH	STATE: CA	ZIP CODE:	93201
CAPACITY:	24	CENSUS: 0	DATE:	01/22/2020
TYPE OF VISIT:	Office	ANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Nancy Ruble		TIME COMPLETED:	10:00 AM

NARRATIVE

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An informal office meeting was conducted on 01/22/2020 at 09:00am at the Fresno Regional Child Care Office. In attendance at the meeting were Alpaugh Preschool Director, Nancy Ruble, Licensing Program Manager (LPM), Susie Fanning, and Licensing Program Analyst (LPA), Rene Mancinas. The purpose of this meeting was to discuss administrative organization status and previous cited deficiencies.

Nancy Ruble has been the Director of the preschool since 2017. The Department has made multiple attempts to obtain necessary documentation and supporting documents in order to proceed with making such changes. The facility has failed to respond to the multiple requests, resulting in the following deficiency being cited on 01/09/2020;

01/09/2020 - Case Management Inspection

California Code of Regulations Title 22 Division 12 Chapter 1
Section 101212(a)(b)
Reporting Requirements
Type B Deficiency

Previous Cited Deficiencies
09/20/2019 - Annual Inspection
California Code of Regulations Title 22 Division 12 Chapter 1
Section 101216.3(a)
Ratio/Supervision
Type B

Disinfectants, Cleaning Solutions accessible
Section 101238(g)
Type B
(Continued on 809-C)

SUPERVISOR'S NAME: Susie Fanning	TELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Rene Mancinas	TELEPHONE: (559) 341-4524
LICENSING EVALUATOR SIGNATURE:	DATE: 01/22/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/22/2020

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: ALPAUGH STATE PS/ALPAUGH U.S.D.	FACILITY NUMBER: 543808691
	VISIT DATE: 01/22/2020

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03/05/2019 – Plan of Correction Inspection
California Health & Safety Code
Section 1597.7995
Staff immunizations
Type B

01/22/2019 – Annual Inspection
California Health & Safety Code
Section 1596.7995
Staff immunizations
Type B

California Code of Regulations Title 22 Division 12 Chapter 1
Section 101239(f)(1)
Fixtures, Furniture, Equipment, and Supplies
Type B

Section 101216.3(a)(b)
101216.3(a)(b)
Ratio/Supervision
Type B

During today's meeting the above was discussed. Nancy provided the requested documents in order to proceed with a change in director request. Additional documents are still pending. The plan of correction has been extended to 02/22/2020.

Nancy is aware that facility is to remain in compliance with California Health & Safety Codes and California Title 22 Regulations pertaining to licensed child care centers.

It was discussed that continued violation(s) of California Health and Safety Codes and California Code of Regulation may result in a Non-Compliance meeting and may be referred to the Department’s Legal Division for possible Administrative Action. A copy of this signed report was given to Director, Nancy Ruble.

SUPERVISOR'S NAME: Susie Fanning	TELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Rene Mancinas	TELEPHONE: (559) 341-4524
LICENSING EVALUATOR SIGNATURE:	DATE: 01/22/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/22/2020

LIC809 (FAS) - (06/04)

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