543810067-3-4-2020-04-CC-PESA-BMDPKD-20200304102257

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 543810067
Report Date: 03/04/2020
Date Signed: 03/04/2020 10:23:02 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-PUSD		FACILITY NUMBER:	543810067
ADMINISTRATOR:	REBECCA ORTEGA-ORTIZ		FACILITY TYPE:	850
ADDRESS:	1345 W PUTNAM AVE		TELEPHONE:	(559) 782-7280
CITY:	PORTERVILLE	STATE: CA	ZIP CODE:	93257
CAPACITY:	24	CENSUS: 21	DATE:	03/04/2020
TYPE OF VISIT:	Case Management - Other	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Rebecca Ortega-Ortiz		TIME COMPLETED:	10:30 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	A Case Management inspection visit was conducted on this date by Licensing Program Analyst Pete Espinoza (LPA), who met with Rebecca Ortega-Ortiz, Program Director. The center is located on the campus of West Putnam Elementary School. The purpose of the visit is to approve relocation of preschool classroom from Room 7 to Room 24 The licensee is requesting a capacity of 24 preschool children. This program will operate year-round, Monday thru Friday from 7:30 AM to 5:30 PM. Children eat breakfast, lunch and snack in classroom. Meals/snacks are prepared on campus in the school cafeteria. Ill children will be isolated in a designated room in the nurse’s office of the elementary school. Room measurements taken and reviewed with Director. The total preschool square footage in Room 24 is 1164 sq. ft., which will accommodate the requested capacity of 24 preschool children. Indoor drinking water is available from drinking fountain in classroom. Adequate storage space in classroom is available for children's belongings. Toys and equipment are age appropriate. Outdoor play area is large enough to accommodate more than the requested capacity of 24 preschool children. Adequate shade is available in the outdoor activity area. There adequate cushioning under climbing structure. There is an igloo for outdoor drinking water. There are 2 toilets and 2 sinks/hand washing fixtures in the children's bathrooms which will accommodate the requested capacity of 24 preschool children. CONTINUED ON FOLLOWING PAGE

SUPERVISOR'S NAME: Diana deLeon	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Peter Espinoza	TELEPHONE: 661-644-8231
LICENSING EVALUATOR SIGNATURE:	DATE: 03/04/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2020

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 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: WEST PUTNAM PS-PUSD	FACILITY NUMBER: 543810067
	VISIT DATE: 03/04/2020

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
26
27
28
29
30
31
32

Incidental Medical Services (IMS) policy was discussed. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. 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.

A recommendation will be made to license the above facility for a capacity of 24 preschool children, ages 2 to 6 years old.

The following documents should be posted at the facility:
· PUB 269 – child passenger restraint systems poster
· PUB 393 – Notification of Parents Rights
· License
· Menus
· LIC 613A – Personal Rights form
· LIC 610 – Disaster Plan
· LIC 948B – Earthquake Preparedness Checklist

To order forms, etc. visit our website at www.ccld.ca.gov

This report must be filed in your facility file for public review for a period of 3 years.

SUPERVISOR'S NAME: Diana deLeon	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Peter Espinoza	TELEPHONE: 661-644-8231
LICENSING EVALUATOR SIGNATURE:	DATE: 03/04/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2020

LIC809 (FAS) - (06/04)

Page: 2 of 2