100407512-3-3-2023-04-CC-AGIN-CPKT7H-20230303132845

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 100407512
Report Date: 03/03/2023
Date Signed: 03/03/2023 01:28:51 PM

Document Has Been Signed on 03/03/2023 01:28 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:	JEFFERSON STATE PRESCHOOL		FACILITY NUMBER:	100407512
ADMINISTRATOR:	TARA LOGAN		FACILITY TYPE:	850
ADDRESS:	1880 FOWLER		TELEPHONE:	(559) 327-9186
CITY:	CLOVIS	STATE: CA	ZIP CODE:	93611
CAPACITY: 60	TOTAL ENROLLED CHILDREN: 60	CENSUS: 26	DATE:	03/03/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Christina Servin		TIME COMPLETED:	01:45 PM

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On 3/3/23 Licensing Program Analyst (LPA) Araceli Gibson, conducted an unannounced annual inspection. LPA met with Teacher Director, Christina Servin and Heather Holley-Sharp. Preschool has two sessions for preschool AM with 26 children between P1 and P4 present today. This licensed facility is located on the Jefferson Elementary school campus and occupies rooms P1, P3, and P4. This year’s program is utilizing classrooms P1 and P4 for preschool. P3 is not utilized as preschool classroom, but will continue to maintain the space as a preschool setting, which includes equipment and furniture to continue with the capacity and limitations of the license for future use. LPA toured the facility, both indoors and outdoors to inspect areas accessible to children in care. Waiver is maintained for toilets and handwashing stations for P3. CCLD will continue in communications in writing with regard to capacity and limitation for classroom P3 for licensing requirements on a case by case basis.

This year the school year started 08/22/22 and ends on 06/09/22 and operates Monday through Friday from 8:00 AM to 11:00 AM and 11:45 AM to 2:45 PM. 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.

Playground, furniture and equipment are in safe condition, free of sharp, loose or pointed parts. The surface of the outdoor activity space is maintained and monitored for hazards. All toilets and handwashing facilities are in safe and sanitary operating condition. LPA discussed with staff an issue with a slow draining sink filled with soap suds LPA was informed of work order already in place for repair. Breakfast is prepared and served in the cafeteria in the morning. Lunch is served in the classroom for the preschool children in the PM session. 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. Drinking water is available both indoors and outdoors. Currently bottled water is being provided through Valley Springs water company for the children and staff.

continue 809C

SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Araceli Gibson
LICENSING EVALUATOR SIGNATURE:	DATE: 03/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2023

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: JEFFERSON STATE PRESCHOOL	FACILITY NUMBER: 100407512
	VISIT DATE: 03/03/2023

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Play yard has working water fountains accessible to small children. Areas around high climbing equipment, swings and slides have cushioning material to absorb falls. The facility is free of flies, insects and rodents. Facility has one or more functioning carbon monoxide detectors that meet statutory requirements. As a condition of employment for is for all staff to have a fingerprint clearance through Clovis Unified School District prior to working or volunteering in a licensed child care facility, all individuals subject to a criminal record review have received a criminal record clearance or exemption. Upon notification from the Department, the licensee will comply and act immediately to terminate the employment of, remove from the facility or bar from entering the facility for any person it is deemed necessary while the Department considers granting or denying an exemption. Capacity and limitations as specified on the license are being maintained.

Assembly Bill 2370, Chapter 676, Statutes of 2018 requires all Child Care Centers (CCCs) that are located in buildings constructed before January 1, 2010 to test their drinking water for lead contamination by January 1, 2023 and every 5 years thereafter. This facility has provided evidence of completed water testing.

At least one person trained in CPR and Pediatric First Aid is present when children are at the facility or at offsite activities. The name of the child care center director or fully-qualified teacher designated to act in the director’s absence has been reported to the Department. Facility is maintaining signing children in/out of the facility by authorized representatives at the site. All children are under supervision, including visual supervision, of a teacher at all times while virtual learning format. Facility maintains a ratio of one teacher supervising no more than 12 children in care when in person learning is conducted. LPA reviewed a sample of children’s files and observed files were complete with contact information for authorized representative and or relatives or others who can assume responsibility for the child and medical assessment. LPA reviewed a sample of 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. Menus are posted at least one week in advance where an authorized representative can view them.

Incidental Medical Services (IMS) are currently being provided. Information regarding Americans with Disability Act (ADA) can be obtained by contacting US Department of Justice toll free ADA Information line at (800) 514-0301(voice), (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm.

SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Araceli Gibson
LICENSING EVALUATOR SIGNATURE:	DATE: 03/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2023

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
FRESNO-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: JEFFERSON STATE PRESCHOOL	FACILITY NUMBER: 100407512
	VISIT DATE: 03/03/2023

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website www.ccld.ca.gov which will provide 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.

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

This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.

SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Araceli Gibson
LICENSING EVALUATOR SIGNATURE:	DATE: 03/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2023

LIC809 (FAS) - (06/04)

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