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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543808789
Report Date: 11/18/2019
Date Signed: 11/19/2019 10:11:15 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:TCSD/ALPINE VISTA TITLE ONE PRESCHOOLFACILITY NUMBER:
543808789
ADMINISTRATOR:MARTINDALE, TERRIFACILITY TYPE:
850
ADDRESS:2975 E ALPINE AVETELEPHONE:
(559) 685-7200
CITY:TULARESTATE: CAZIP CODE:
93274
CAPACITY:20CENSUS: 18DATE:
11/18/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
01:50 PM
MET WITH:Rebecca PattersonTIME COMPLETED:
02:40 PM
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On this date, Licensing Program Analyst (LPA) Kathy Pacheco conducted an unannounced annual/random inspection. LPA met with Lead Teacher, Rebecca Patterson. A tour of the facility was conducted, inside and outside, as shown on the facility sketch. There were no bodies of water, firearms and/or ammunition on the premises. Disinfectants, hazardous items and medications were inaccessible to children. Storage area for poisons was locked and inaccessible to children. Furniture, equipment and material were sufficient, age appropriate, in good repair and toxic free. The playground equipment and outdoor activity space was maintained and in good condition, free of hazards with adequate cushioning material. Children's toilets and hand washing facilities were sanitary and in good operating condition. Rooms and floors were safe and clean. Food preparation area was clean and free of rodent and other vermin. Contaminated food was discarded immediately, when applicable. Storage containers for solid waste were in good repair with tight-fitting covers. Sanitary drinking water was available both indoors and outdoors. The Licensee was taking measures to keep the facility free of insects, rodents, etc. No excluded adults were present at the facility. Conditions, limitations and capacity specified on license were in compliance. Criminal record clearance records are completed as condition for employment and maintained by the Tulare City School District. First Aid/CPR reviewed and in compliance. Qualified staff designated to act in the Director’s absence has been reported accordingly. Sign In/Sign Out sheets had 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 records reviewed. Children’s records included required medical and consent for emergency medical.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records.

LPA provided Licensee with information regarding AB 2370, Chapter 676, Statutes of 2018, requiring child care providers to inform parents and/or guardians with lead safety information.
(continued on next page)
SUPERVISOR'S NAME: Michael DuarteTELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Kathy PachecoTELEPHONE: (559) 341-5116
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2019
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 2
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: TCSD/ALPINE VISTA TITLE ONE PRESCHOOL
FACILITY NUMBER: 543808789
VISIT DATE: 11/18/2019
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This facility operates two half day programs. Monday through Friday 8:30 AM to 11:30 AM and 12:30 PM to 3:30 PM.

NO DEFICIENCIES OBSERVED IN THE AREAS INSPECTED TODAY.

LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS.
SUPERVISOR'S NAME: Michael DuarteTELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Kathy PachecoTELEPHONE: (559) 341-5116
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2019
LIC809 (FAS) - (06/04)
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