<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543810067
Report Date: 02/20/2020
Date Signed: 02/20/2020 08:40:57 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:WEST PUTNAM PS-PUSDFACILITY NUMBER:
543810067
ADMINISTRATOR:REBECCA ORTEGA-ORTIZFACILITY TYPE:
850
ADDRESS:1345 W PUTNAM AVETELEPHONE:
(559) 782-7280
CITY:PORTERVILLESTATE: CAZIP CODE:
93257
CAPACITY:24CENSUS: 21DATE:
02/20/2020
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
07:30 AM
MET WITH:Rebecca Ortega-OrtizTIME COMPLETED:
09:00 AM
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
Licensing Program Analyst (LPA) Brannon met with Director of Early Learning, Rebecca Ortega-Ortiz. During today's visit, LPA reviewed the new classroom that licensee wishes to utilize as the new preschool classroom. The preschool is located at the West Putnam Elementary School. Licensee is currently utilizing classroom # 7. Licensee would like to change classrooms from classroom # 7 to classroom #24. The new classroom is not set up for the preschool children. Another visit has been scheduled to inspect the preschool classroom.

During today's visit, LPA observed three staff with 21 children.

The following documents should be posted at the facility:
* PUB 269- Child passenger restraint systems poster 101225(f) Transportation
* Pub 393- Notification of Parents Rights 101218.1(c) Admission Procedures
* License 101160(a) License
* Menus 101227(a)(6) Food Services
* LIC 613A- Personal Rights form 101223(b)(2) Personal Rights
* LIC 610- Disaster Plan 101174(a)
* LIC 9148- Earthquake Preparedness Checklist 101174(b)
* Lead Poisoning brochure

To order forms, etc. visit our website at www.ccld.ca.gov.
SUPERVISOR'S NAME: Michael DuarteTELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Cynthia BrannonTELEPHONE: (559) 341-5155
LICENSING EVALUATOR SIGNATURE:

DATE: 02/20/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/20/2020
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 1