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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543808691
Report Date: 09/20/2019
Date Signed: 09/20/2019 02:22:25 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:ALPAUGH STATE PS/ALPAUGH U.S.D.FACILITY NUMBER:
543808691
ADMINISTRATOR:HUDSON, ROBERT M.FACILITY TYPE:
850
ADDRESS:5313 ROAD 39TELEPHONE:
(559) 949-8305
CITY:ALPAUGHSTATE: CAZIP CODE:
93201
CAPACITY:24CENSUS: 14DATE:
09/20/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Nancy RubleTIME COMPLETED:
02:50 PM
NARRATIVE
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An unannounced annual inspection was conducted today by Licensing Program Analyst (LPA) Rene Mancinas JR. LPA met with Site Administrator, Nancy Ruble. This is a single classroom facility housed on the Alpaugh Elementary School campus. LPA toured the facility, both indoors and outdoors to inspect areas accessible to children in care. LPA observed a fenced playground area, which included a slide, sandbox, and tricycle track area. LPA observed safe play equipment and adequate shading on this accessible outdoor play area during today’s inspection. Outdoor activity space surface is maintained in a safe condition and is free of hazards. Firearms/weapons are not allowed or stored on premises. All children are under supervision, including visual supervision, of a teacher at all times. No poisons were observed during today’s inspection. Medications, when stored at the facility, are locked and stored in area inaccessible to day care children. There are two restrooms located in the classroom for children to use. Restrooms were clean and toilets and hand washing sinks were in operable conditions. Furniture and equipment are in good condition, free of sharp, loose, or pointed parts. Solid waste storage vessels, including moveable bins, have tight-fitting covers on, are in good repair. Uncontaminated drinking water is available both indoors and outdoors. Menus are posted at least one week in advance, where an authorized representative can view them.

CCL shall notify a licensee to immediately terminate the employment of, or to remove/bar any person with specified convictions or for other reasons. The licensee shall comply with the notice. Before working or volunteering in a licensed child care facility, all individuals subject to a criminal record review have a clearance or exemption and have been associated to the facility.

Child's admission agreement is available for review. Meals are prepared off site by the main school’s cafeteria and served to the children in the classroom.

HOURS OF OPERATION: Year-round/Monday through Friday: 08:00am to 03:00pm, with half-day/part-time options available. (Continued on 809-C).

SUPERVISOR'S NAME: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Rene MancinasTELEPHONE: (559) 341-4524
LICENSING EVALUATOR SIGNATURE:

DATE: 09/20/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2019
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 3
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: 09/20/2019
NARRATIVE
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Required CCL forms are posted on parent's board. Incidental Medical Services (IMS) policy was discussed. LPA informed Site Administrator of the Community Care Licensing Division website, which provides access to Provider Information Notices (PINs), Quarterly Updates, Mandated Reporter Training, Safe Sleep information, Lead Poisoning information, forms available for print, and information regarding Department regulations.

During today’s inspection the following deficiencies were observed;

Upon entry into the classroom, LPA observed staff member #1 by themselves in the classroom. Staff member #1 greeted LPA and then escorted him to the outside area where 13 children were playing outdoors, while under the supervision of staff member #2. Staff member #1 stated she had entered the classroom briefly for “2 minutes” to “call in attendance.” LPA informed staff member #1 and Site Administrator that staff members are to comply with staff-to-child ratio as required per regulations.

During inspection of the indoor classroom area, LPA observed a low cabinet that had a safety-latch secured to one of the two handles, thus making the cabinet accessible to children in care. LPA opened the cabinet to inspect contents inside the unlocked/accessible cabinet. LPA discovered Ajax cleaning solution, floor cleaner, and bathroom cleaner. LPA informed Site Administrator that such hazardous items are to be made inaccessible to children per regulations. LPA advised to ensure that safety latches are secured/locked immediately after staff members have accessed the cabinets.

End of deficiencies observed.

Per California Code of Regulations Title 22 Division 12 Chapter 1; the following deficiencies are being cited. (See 809-D). Appeal rights were provided. Exit interview conducted with Site Administrator Nancy Ruble. Notice of Site Visit to be posted for 30 days.

SUPERVISOR'S NAME: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Rene MancinasTELEPHONE: (559) 341-4524
LICENSING EVALUATOR SIGNATURE:

DATE: 09/20/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2019
LIC809 (FAS) - (06/04)
Page: 2 of 3
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/20/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/20/2019
Section Cited

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There shall be a ratio of one teacher visually observing and supervising no more than 12 children in attendance, except as specified in (b) and (c). This requirement was not met as evidenced during today's inspection.
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(See 809-C for further details). This poses a potential risk to the health, safety, and personal rights of children in care.
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focus on staff-to-child ratios as required by regulations. Nancy agreed to submit staff meeting agenda/memo to CCLD Fresno Child Care by 10/21/2019.
Type B
09/20/2019
Section Cited

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Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children shall be stored where inaccessible to children. This requirement was not met as evidenced during today's inspection.
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(See 809-C for further details). This poses a potentail risk to the health, safety, and 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: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Rene MancinasTELEPHONE: (559) 341-4524
LICENSING EVALUATOR SIGNATURE:
DATE: 09/20/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/20/2019
LIC809 (FAS) - (06/04)
Page: 3 of 3