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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543810043
Report Date: 11/18/2019
Date Signed: 11/18/2019 01:58:09 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:VUSD-CRESTWOOD ELEMENTARY SCHOOL E.L.C.FACILITY NUMBER:
543810043
ADMINISTRATOR:AMY SULLIVANFACILITY TYPE:
850
ADDRESS:3001 W WHITENDALETELEPHONE:
(559) 730-7564
CITY:VISALIASTATE: CAZIP CODE:
93277
CAPACITY:96CENSUS: 49DATE:
11/18/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Margaret McLainTIME COMPLETED:
02:15 PM
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On this date, Licensing Program Analyst (LPA) Theresa Marquez conducted an unannounced Annual inspection and met with Early Childhood Education (ECE) Lead, Margaret McLain. The program consist of 4 classrooms. LPA Marquez toured all 4 classrooms, both indoors and outdoors. All children are under supervision, including visual supervision, of a teacher at all times. There is a ratio of one teacher supervising no more than 12 children in attendance.

This is an AM/PM half day which operates on a traditional school year schedule. The morning session is 8:00AM to 11:00AM and the afternoon session is 12:00 PM to 3:00 PM, Monday through Friday. Required CCL forms are posted on parent's board.

Furniture and equipment are in good condition. All materials and surfaces accessible to children are toxic free. All floors are clean and safe. The facility provides a meal to both AM and PM sessions, snacks are not provided. Meals are prepared off-site at another Visalia Unified School location and delivered to this site. Menus are posted at least one week in advance, where an authorized representative can view them. All toilets and hand washing facilities are in safe and sanitary operating conditions.

Playground equipment is in good condition, free of sharp, loose, or pointed parts.
Areas around high climbing equipment, and slides have cushioning material to absorb falls. Uncontaminated drinking water is available both indoors and outdoors.
There are no bodies of water on site. Firearms/weapons are not allowed or stored on premises. Facility has one or more functioning carbon monoxide detectors that meet statutory requirements.

Continued on LIC809-C
SUPERVISOR'S NAME: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Theresa MarquezTELEPHONE: (559) 341-7123
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)
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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: VUSD-CRESTWOOD ELEMENTARY SCHOOL E.L.C.
FACILITY NUMBER: 543810043
VISIT DATE: 11/18/2019
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Staff records contain appropriate, documentation of education credits. Criminal record clearance records are completed as condition for employment and maintained by the Visalia Unified School District.
At least one person trained in CPR and Pediatric first-aid is present when children are at the facility or at off-site activities. The person, who signs the child in/out, is responsible for the child, uses their full legal signature and records the time of day. Child's admission agreement is available for review.

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

The following information regarding Americans with Disability Act (ADA) was provided: US Department of Justice toll free ADA Information line at (800) 514-0301(voice) and (800) 514-0383 (TDD) and website link
https://www.ada.gov/childqanda.htm for Commonly Asked Questions about Child Care Centers and the ADA.

The Director is to provide the updated licensing forms: LIC 500 - Personnel Report; LIC 308 Designation of Administrative Responsibility; LIC 610 Emergency Disaster Plan.



Per Chapter 1, Division 12, Title 22 of the California Code of Regulations no deficiencies are observed today.

THIS REPORT SHALL BE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.

LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS.
SUPERVISOR'S NAME: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Theresa MarquezTELEPHONE: (559) 341-7123
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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