103801670-8-22-2024-04-CC-KVAG-D8DTLG-20240822144927

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 103801670
Report Date: 08/22/2024
Date Signed: 08/22/2024 02:49:37 PM

Document Has Been Signed on 08/22/2024 02:49 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 RO, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME:	FUSD-COLUMBIA		FACILITY NUMBER:	103801670
ADMINISTRATOR/ DIRECTOR:	KUE YANG		FACILITY TYPE:	850
ADDRESS:	1025 S. TRINITY		TELEPHONE:	(559) 457-3690
CITY:	FRESNO	STATE: CA	ZIP CODE:	93706
CAPACITY: 22	TOTAL ENROLLED CHILDREN: 22	CENSUS: 3	DATE:	08/22/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	12:10 PM
MET WITH:	Kue Yang, Site Supervisor		TIME VISIT/ INSPECTION COMPLETED:	03:05 PM

NARRATIVE

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On 08/22/2024, Licensing Program Analysts (LPAs) Ka Vang and Xona Xayavong conducted an unannounced Annual Random Inspection and was met by Site Supervisor Kue Yang. This facility runs two half day programs operating on a year round school schedule from August to June. The AM session is from Monday to Friday, 8:00 AM to 11:00 AM; the PM session is from Monday to Friday, 12:00 PM to 3:00 PM. LPAs confirmed the facility has a working telephone service at (559) 457-3690.

This facility provides AM/PM snacks and lunch meals to children in care. The food is prepared on site. Menus are posted at least one week in advance where parent or an authorized representative can view them.

LPAs toured the facility indoors and outdoors, and a census was taken. All children are under supervision, including visual supervision, of a qualified teacher at all times. There is a ratio of one teacher supervising no more than twelve 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 to children. No poisons were observed during the inspection.

During the inspection, LPAs observed furniture and equipment are in good condition, free of sharp, loose, or pointed parts. All toilets and handwashing facilities are in safe and sanitary operating condition. All floors are clean and safe. All kitchen, food preparation and storage areas are clean. The facility is free of flies, insects, and rodents. Facility has one or more functioning carbon monoxide detectors that meet the statutory requirements. LPAs observed Solid waste storage containers are in good condition. Drinking water is available both indoors and outdoors as drinking water is provided by drinking fountains.

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SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Ka Vang
LICENSING EVALUATOR SIGNATURE:	DATE: 08/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2024

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 08/22/2024 02:49 PM - It Cannot Be Edited

Created By: Ka Vang On 08/22/2024 at 01:46 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-COLUMBIA	FACILITY NUMBER: 103801670
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/22/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. 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. LPAs observed Site Supervisor/Teacher did not have current mandated reporter training. This poses a potential health, safety, or personal rights risk to children in care.
	POC Due Date: 09/05/2024
	Plan of Correction
1 2 3 4	Per Site Supervisor, she agrees to submit proof that she has current mandated reporter training. The proof is to be submitted to the Department by 09/05/2024.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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:

Juvenal Moctezuma

LICENSING EVALUATOR NAME:

Ka Vang

LICENSING EVALUATOR SIGNATURE:

DATE: 08/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2024

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 RO, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: FUSD-COLUMBIA	FACILITY NUMBER: 103801670
	VISIT DATE: 08/22/2024

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Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1- CCP). LPAs verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

There is a working fire extinguisher and carbon monoxide detector and adequate heating and ventilation for safety and comfort. Fire drills are conducted and documented with the date, time and how many children present, every six months.

LPAs discussed the safe sleep regulations with licensee Site Supervisor and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPAs also informed licensee Site Supervisor of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Upon notification from the Department, Site Supervisor 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.

LPAs 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. LPAs 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.

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SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Ka Vang
LICENSING EVALUATOR SIGNATURE:	DATE: 08/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2024

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 RO, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: FUSD-COLUMBIA	FACILITY NUMBER: 103801670
	VISIT DATE: 08/22/2024

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At least one person trained in CPR and Pediatric First Aid is present when children are at the facility or at offsite activities. During record review, Site Supervisor did not have a current Mandated Reporter Training; therefore, a deficiency Type B was cited during today’s inspection. Record reviewed and confirmed that Kue Yang meets the qualification of being a site supervisor. The person who signs the child in/out of the facility shall use their full legal signature and record the time of day.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. 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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/

Site Supervisor was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

LPAs and Site Supervisor Kue Yang 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, Safe Sleep in Child Care, Lead Poisoning Facts, Forms and Regulations.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, there are deficiency been cited during today’s inspection. (See page LIC809-D for additional information).

Site Supervisor Kue Yang was provided a copy of appeal rights. A notice of site visit (LIC 9213) was given and must remain posted for 30 days. This report shall be made available to the public upon request. Exit interview conducted and report was reviewed with Site Supervisor Kue Yang.

SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Ka Vang
LICENSING EVALUATOR SIGNATURE:	DATE: 08/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2024

LIC809 (FAS) - (06/04)

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