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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103801858
Report Date: 01/19/2023
Date Signed: 01/19/2023 02:52:55 PM

Document Has Been Signed on 01/19/2023 02:52 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-EASTERBYFACILITY NUMBER:
103801858
ADMINISTRATOR:MADDEN, KATHERINEFACILITY TYPE:
850
ADDRESS:5211 E. TULARE STREETTELEPHONE:
(559) 457-3690
CITY:FRESNOSTATE: CAZIP CODE:
93727
CAPACITY: 22TOTAL ENROLLED CHILDREN: 22CENSUS: 17DATE:
01/19/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Teacher Jewlie Xiong-LeeTIME COMPLETED:
03:15 PM
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On 01/19/2023, Licensing Program Analyst (LPA) Ka Vang conducted an unannounced Annual Required Inspection and was met by Teacher Jewlie Xiong-Lee. This is an AM and PM half day program operates on a traditional school year schedule from August to June. The AM session start 8:15 AM to 11:15 AM and the PM session start 12:00 PM to 3:00 PM, Monday through Friday. This facility has one classroom. Breakfast and lunches are provided in the cafeteria by parent escorted prior to the start of each session for AM and PM.

LPA toured the facility indoors and outdoors, and a census was taken. 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 to children. No poisons were observed during the inspection.

During the inspection, LPA 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. Solid waste storage containers have tight-fitting covers and are in good repair. Drinking water is available both indoors and outdoors.



There is a working fire extinguisher, smoke detector, 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.

Jewlie was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record 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.

(Continued on LIC809-C).

SUPERVISORS NAME: Rene Mancinas
LICENSING EVALUATOR NAME: Ka Vang
LICENSING EVALUATOR SIGNATURE: DATE: 01/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/19/2023
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 3
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: FUSD-EASTERBY
FACILITY NUMBER: 103801858
VISIT DATE: 01/19/2023
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Upon notification from the Department, 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.

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, Jewlie’s Mandated Reporter training was completed on 10/02/2021. Jewlie’s pediatric CPR/First Aid expires on 01/2023. Jewlie provided proof that she is scheduled to renew her CPR/First Aid training on 01/21/2023. 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 person who signs the child in/out of the facility shall use their full legal signature and record the time of day. All children are under supervision, including visual supervision, of a teacher at all times. Facility maintains a ratio of one teacher supervising no more than 12 children in attendance.



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.

Incidental Medical Services (IMS) policy discussed, and facility is not providing IMS. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing 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)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/childqanda.htm.

LPA and Teacher 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.

(Continued on LIC809-C).

SUPERVISORS NAME: Rene Mancinas
LICENSING EVALUATOR NAME: Ka Vang
LICENSING EVALUATOR SIGNATURE:

DATE: 01/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/19/2023
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: FUSD-EASTERBY
FACILITY NUMBER: 103801858
VISIT DATE: 01/19/2023
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To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.


Per the California Code of Regulations, Title 22, Division 12, Chapter 1, no deficiency is been cited during today’s inspection.

Jewlie was provided a copy of appeal rights. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with Jewlie.
SUPERVISORS NAME: Rene Mancinas
LICENSING EVALUATOR NAME: Ka Vang
LICENSING EVALUATOR SIGNATURE:

DATE: 01/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/19/2023
LIC809 (FAS) - (06/04)
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