103801249-9-9-2021-04-CC-SGAN-C6PVVA-20210909164601

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 103801249
Report Date: 09/09/2021
Date Signed: 09/09/2021 04:46:20 PM

Document Has Been Signed on 09/09/2021 04:46 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
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME:	ST. HELEN'S JUNIOR KINDERGARTEN PRESCHOOL		FACILITY NUMBER:	103801249
ADMINISTRATOR:	RODRIGUEZ, DENAE CRUZ		FACILITY TYPE:	850
ADDRESS:	4888 E. BELMONT AVENUE		TELEPHONE:	(559) 251-4846
CITY:	FRESNO	STATE: CA	ZIP CODE:	93727
CAPACITY: 30	TOTAL ENROLLED CHILDREN: 30	CENSUS: 11	DATE:	09/09/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:40 PM
MET WITH:	Denae Rodriguez		TIME COMPLETED:	05:00 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 9/9/2021, Licensing Program Analysts (LPAs) Stefanie Galvan and Luisa Gavoutian, conducted an unannounced Annual Inspection. LPAs met with Director/Teacher, Denae Rodriguez, who accompanied LPAs on a tour of the facility, indoors and outdoors. This is a full day program which operates on a traditional school year schedule from 8:00 a.m. to 3:00 p.m., Monday through Friday. 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 hand washing 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. Breakfast and lunch are provided by parents for each child from home. The facility does provide snacks and water for drinking. All kitchen, food preparation, and storage areas are clean, free of litter/rubbish and rodents/vermin. 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. Playground equipment is in safe condition, free of sharp, loose, or pointed parts. LPAs observed the areas below high climbing equipment, such as slides and monkey bars to be in need of a refill of cushioning material. Currently this facility uses rubber pellets to absorb falls. Continued on 809-C

SUPERVISORS NAME: Alice Juarez
LICENSING EVALUATOR NAME: Stefanie Galvan
LICENSING EVALUATOR SIGNATURE:	DATE: 09/09/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2021

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 9

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: ST. HELEN'S JUNIOR KINDERGARTEN PRESCHOOL	FACILITY NUMBER: 103801249
	VISIT DATE: 09/09/2021

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

Facility representative was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Community Care Licensing (CCL) shall notify a Licensee to immediately terminate the employment of, or to remove/bar any person with specified convictions or for other reasons; the Licensee shall comply with the notice. 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 off-site activities. Current Director/Teacher, Denae Rodriguez's CPR certification expires 7/2022. The name of the childcare center director or fully qualified teacher(s) designated to act in the director’s absence has been reported to the Department. Mandated Reporter Training is verified for all staff present.

The person who signs the child in/out of the facility uses their full legal signature and records the time of day. LPAs 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. LPAs observed that physician assessments and Tuberculosis risk assessments were missing from children's files. LPAs also observed that Admission Agreements for children were not readily available for inspection. LPA reviewed a sample of staff files and observed files were complete with health screening, but missing immunization records for influenza, pertussis, and measles.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. This facility will submit an IMS plan to CCL within 30 days. 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.

Continued on 809-C

SUPERVISORS NAME: Alice Juarez
LICENSING EVALUATOR NAME: Stefanie Galvan
LICENSING EVALUATOR SIGNATURE:	DATE: 09/09/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2021

LIC809 (FAS) - (06/04)

Page: 5 of 9

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: ST. HELEN'S JUNIOR KINDERGARTEN PRESCHOOL	FACILITY NUMBER: 103801249
	VISIT DATE: 09/09/2021

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

LPAs and Director discussed the 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.

Per Chapter 1, Division 12, Title 22 of the California Code of Regulations no deficiencies were observed today.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with facility representative Denae Rodriguez.

SUPERVISORS NAME: Alice Juarez
LICENSING EVALUATOR NAME: Stefanie Galvan
LICENSING EVALUATOR SIGNATURE:	DATE: 09/09/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2021

LIC809 (FAS) - (06/04)

Page: 9 of 9