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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 100406338
Report Date: 09/06/2023
Date Signed: 09/06/2023 03:37:08 PM

Document Has Been Signed on 09/06/2023 03:37 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:FUSD-MAYFAIRFACILITY NUMBER:
100406338
ADMINISTRATOR:MADDEN, KATHERINEFACILITY TYPE:
850
ADDRESS:3305 E. HOMETELEPHONE:
(559) 457-3690
CITY:FRESNOSTATE: CAZIP CODE:
93703
CAPACITY: 42TOTAL ENROLLED CHILDREN: 42CENSUS: 8DATE:
09/06/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:25 PM
MET WITH:Fatima VasquezTIME COMPLETED:
04:00 PM
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On September 6, 2023, Licensing Program Analyst (LPA) Anita Tristan and Licensing Program Manager (LPM) Cynthia Brannon conducted a case management inspection.

During today's inspection, LPA observed that the outside drinking water fountain is covered with vines, trash in the basin and is not working. Staff does not utilize an igloo, or other container, to provide outside uncontaminated drinking water for children in care. Licensee will provide a disposable cup dispenser with disposable cups.

Per Title 22, section Drinking water, 101239.2 (a)(1) Drinking water from a non-contaminating fixture or container shall be readily available both indoors and in the outdoor activity area. This allows children to drink freely as they wish.

Per California Code of Regulations, Title 22, Division 12, Chapter 1, this deficiency is to be cited. Exit interview conducted with Health and Safety Supervisor, Charlotte Miranda. Plan Of Correction/Appeal Rights were given and discussed. A Notice of Site Visit was posted on parent board for 30 days.

SUPERVISORS NAME: Cynthia Brannon
LICENSING EVALUATOR NAME: Anita Tristan
LICENSING EVALUATOR SIGNATURE: DATE: 09/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/06/2023
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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Document Has Been Signed on 09/06/2023 03:37 PM - It Cannot Be Edited


Created By: Anita Tristan On 09/06/2023 at 02:56 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: FUSD-MAYFAIR
FACILITY NUMBER: 100406338

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/06/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/20/2023
Section Cited
CCR
101239.2(a)(1)

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Drinking water - from a noncontaminating fixture or container shall be readily available both indoors and in the outdoor activity area. Children shall be free to drink as they wish.
Drinking water fountain is covered with vines, trash in the basin and is not working. Water is not readily available outdoors for children in care.
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Per Health and Safety Supervisor, Licensee will work with maintenance to fix the outside drinking water fountain. Licensee ensure an igloo, or other container, to provide outside uncontaminated drinking water for children in care. Licensee will provide a disposable cup dispenser with disposable cups.
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LPA observation and interviews reflect this requirement is not being met. This poses an potential risk of personal rights, health and safety to children in care.
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A photograph of required items will be sent to the Fresno Community Care Licensing office by 9/20/23.

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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Cynthia Brannon
LICENSING EVALUATOR NAME:Anita Tristan
LICENSING EVALUATOR SIGNATURE:
DATE: 09/06/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/06/2023


LIC809 (FAS) - (06/04)
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