103801669-8-16-2022-04-CC-ASLR-CHCR8A-20220816124738

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 103801669
Report Date: 08/16/2022
Date Signed: 08/16/2022 12:48:16 PM

Document Has Been Signed on 08/16/2022 12:48 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:	FUSD-FREMONT		FACILITY NUMBER:	103801669
ADMINISTRATOR:	MADDEN, KATHERINE		FACILITY TYPE:	850
ADDRESS:	1005 W. WELDON		TELEPHONE:	(559) 457-3690
CITY:	FRESNO	STATE: CA	ZIP CODE:	93705
CAPACITY: 22	TOTAL ENROLLED CHILDREN: 14	CENSUS: 0	DATE:	08/16/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Celeste Coffman		TIME COMPLETED:	01:00 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 08/16/22, Licensing Program Analyst (LPA) Angelica Slaughter conducted an unannounced annual inspection at the facility. LPA met with Site Supervisor, Celeste Coffman and toured the facility indoors and outdoors. This facility is located on Fremont Elementary School grounds and uses classroom #29. There were no bodies of water, firearms and/or ammunition on the premises. No poisons were observed during the inspection. Furniture and equipment were in good condition, free of sharp, loose or pointed parts. Playground equipment was in safe condition, free of sharp, loose or pointed parts. The surface of the outdoor activity space was maintained in a safe condition and was free of hazards. Areas around high climbing equipment and slides have wood chip cushioning material to absorb falls. Children's toilets and hand washing facilities were sanitary and in good operating condition. Floors in the facility were clean and safe. Meals are not provided in the classroom; however, parents can escort their children to the elementary school cafeteria prior to or after class for meals. Snacks are provided in the classroom and are prepared in the school cafeteria. The facility was free of flies, insects, and rodents/vermin. Solid waste storage containers had tight-fitting covers and were in good repair. Menus are posted at least one week in advance where an authorized representative can view them. Drinking water was available both indoors and outdoors. The facility had one or more functioning carbon monoxide detectors that meet statutory requirements. Capacity and limitations as specified on the license are being maintained. The name of the child care center Director or fully qualified teacher(s) designated to act in the Director's absence has been reported to the Department. The facility maintains a ratio of one teacher supervising no more than 12 children in care. All children are under supervision, including visual supervision, of a teacher at all times. The person who signs the child in/out of the facility shall use their full legal signature and record the time of day. A sample of children's files were reviewed and contained contact information for authorized representative and/or relatives or others who can assume responsibility for the child and medical assessment. LPA also reviewed a sample of staff files and observed they contained health screening, immunization records for influenza, pertussis, and measles. Site Supervisor was reminded all staff should have current documentation of completed Mandated Reporter Training and at least one person trained in CPR and pediatric First Aid, when children are present at the facility or at off-site activities.

SUPERVISORS NAME: Diana deLeon
LICENSING EVALUATOR NAME: Angelica Slaughter
LICENSING EVALUATOR SIGNATURE:	DATE: 08/16/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2022

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 08/16/2022 12:48 PM - It Cannot Be Edited

Created By: Angelica Slaughter On 08/16/2022 at 12:25 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-FREMONT	FACILITY NUMBER: 103801669
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/16/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(c)

Administration of Child Day Care Licensing

(c) Current proof of completion for each licensed child day care provider or applicant for that license, administrator, and employee of a licensed child day care facility shall be submitted to the department upon inspection of the child day care or upon request by the department. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in that Site Supervisor did not have proof of completion of the Mandated Reporter Training, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 09/13/2022
	Plan of Correction
1 2 3 4	Site Supervisor stated she will complete the required training and submit a copy of the certicate of training to CCLD by the POC due date of 09/13/22.

Type B

Section Cited

CCR

101216(f)

Personnel Requirements

(f) At least one staff member who is trained in pediatric cardiopulmonary resuscitation and pediatric first aid pursuant to Health and Safety Code Section 1596.866 shall be present when children are at the child care center or offsite for center activities. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in that Site Supervisor's CPR/1st Aid certification expired in January 2022, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 09/13/2022
	Plan of Correction
1 2 3 4	Site Supervisor stated she will complete the required CPR/1st Aid training and submit a copy of the certicate of training to CCLD by the POC due date of 09/13/22.

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:

Diana deLeon

LICENSING EVALUATOR NAME:

Angelica Slaughter

LICENSING EVALUATOR SIGNATURE:

DATE: 08/16/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2022

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
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: FUSD-FREMONT	FACILITY NUMBER: 103801669
	VISIT DATE: 08/16/2022

NARRATIVE

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Criminal record clearance records are completed as a condition for employment and maintained by Fresno Unified School District.

This facility operates two half day programs. Morning session operates from 8:00 AM to 11:00 AM and afternoon session operates from 12:00 PM to 3:00 PM, Monday through Friday.

This facility provides Incidental Medical Services - IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children's, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation interpretations and Procedures for Child Care Centers Section 101173 and 101226. 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

LPA and Site Supervisor discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINs), Quarterly Updates, COVID-19 Information and Resources, Mandated Reporter Training, Lead Poisoning Facts, Forms and Regulations.

Per Title 22, Division 12, Chapter 1 of the California Code of Regulations, the following deficiencies were found (see next page):

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Site Supervisor Celeste Coffman.

SUPERVISORS NAME: Diana deLeon
LICENSING EVALUATOR NAME: Angelica Slaughter
LICENSING EVALUATOR SIGNATURE:	DATE: 08/16/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2022

LIC809 (FAS) - (06/04)

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