543810047-10-14-2021-04-CC-PESA-C7SSGH-20211014135158

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 543810047
Report Date: 10/14/2021
Date Signed: 10/14/2021 01:52:05 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:	OLIVE PS 255-PUSD		FACILITY NUMBER:	543810047
ADMINISTRATOR:	REBECCA ORTEGA-ORTIZ		FACILITY TYPE:	850
ADDRESS:	255 OLIVE AVE		TELEPHONE:	(559) 782-7120
CITY:	PORTERVILLE	STATE: CA	ZIP CODE:	93257
CAPACITY:	24	CENSUS: 9	DATE:	10/14/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:15 AM
MET WITH:	Rebecca Ortega, Early Learning Program Director		TIME COMPLETED:	02:00 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 10/14/2021, Licensing Program Analyst (LPA) Pete Espinoza, conducted an unannounced Annual Inspection. LPA met with Rebecca Ortega, Early Learning Program Director. LPA toured facility, indoors and outdoors. This is a full day program which operates Monday - Friday 8:10 AM - 4:45 PM on a traditional school year schedule. 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. There is no swimming pool or other bodies of water on the premises. There are no firearms or ammunition allowed or stored on the premises. Disinfectants, cleaning solutions, medication, and other hazardous items are made inaccessible. No poisons were observed during the inspection. Furniture and equipment are in good condition, free of sharp, loose, or pointed parts. All toilets and handwashing facilities are in safe and sanitary operating condition. All floors are clean and safe. The facility is free of flies, insects and rodents. Facility has one or more functioning carbon monoxide detectors that meet statutory requirements. Meals are prepared in school cafeteria. Children eat all meals in the classroom. All food is protected against contamination and any contaminated food is discarded immediately. Solid waste storage containers have tight-fitting covers and 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. Playground equipment is in safe condition, free of sharp, loose, or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. Areas around high climbing equipment, swings, and slides have cushioning material in the form of wood chips to absorb falls.

SUPERVISOR'S NAME: Diana deLeon	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Peter Espinoza	TELEPHONE: 661-644-8231
LICENSING EVALUATOR SIGNATURE:	DATE: 10/14/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2021

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: OLIVE PS 255-PUSD	FACILITY NUMBER: 543810047
	VISIT DATE: 10/14/2021

NARRATIVE

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Criminal record clearance records are completed as condition for employment and maintained by the Porterville Unified

Capacity and limitations as specified on the license are being maintained. At least one person trained in Pediatric CPR and First Aid is present when children are at the facility or at offsite activities. The person who signs the child in/out of the facility uses their full legal signature and records the time of day. LPA reviewed a sample of children’s files and observed files were complete with contact information for authorized representatives or others who can assume responsibility if the authorized representative cannot be reached. LPA observed that all children’s files contained a medical assessment. LPA reviewed staff files and observed files were complete with health screening, immunization records for influenza, pertussis, and measles, and current documentation of completed mandated reporter training.

This facility does not provide Incidental Medical Services (IMS) at this time. 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

LPA discussed the Community Care Licensing (CCL) website (www.ccld.ca.gov) which provides access to Provider Information Notices (PINs), Quarterly Updates, COVID-19 Information and Resources, Mandated Reporter Training, Safe Sleep in Child Care, Lead Poisoning Facts, Forms and Regulations.

Prior to the end of Inspection, Ms. Ortega was called to another meeting and Abigail Felix, Secretary, signed Report.

Per Chapter 1, Division 12, Title 22 of the California Code of Regulations no deficiencies were observed today. Exit interview conducted and report was reviewed with the facility representative Rebecca Ortega, Early Learning Program Director.

A notice of site visit was given and must remain posted for 30 days.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

SUPERVISOR'S NAME: Diana deLeon	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Peter Espinoza	TELEPHONE: 661-644-8231
LICENSING EVALUATOR SIGNATURE:	DATE: 10/14/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2021

LIC809 (FAS) - (06/04)

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