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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103808082
Report Date: 08/24/2022
Date Signed: 08/24/2022 01:36:48 PM

Document Has Been Signed on 08/24/2022 01:36 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-GREENBERGFACILITY NUMBER:
103808082
ADMINISTRATOR:MADDEN, KATHERINEFACILITY TYPE:
850
ADDRESS:5081 E. LANETELEPHONE:
(559) 457-3690
CITY:FRESNOSTATE: CAZIP CODE:
93727
CAPACITY: 27TOTAL ENROLLED CHILDREN: 27CENSUS: 10DATE:
08/24/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Veronica HuertaTIME COMPLETED:
01:45 PM
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On 08/24/22, Licensing Program Analyst (LPA) Angelica Slaughter conducted an unannounced annual inspection at the facility. LPA met with Lead Teacher, Veronica Huerta, and toured the facility indoors and outdoors. This facility is located on Greenberg Elementary School grounds and uses preschool classroom #4B. 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. Facility has a waiver on file for daycare children to utilize school playground located outside the classroom. 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. Snacks are provided to both sessions by the school cafeteria and served in the classroom. Lunch/Meal option is available to children in care, but a parent/guardian is responsible to take their child to the school cafeteria for consumption. The facility currently has an ant infestation, primarily on the counter top in the cabinet area. Lead Teacher stated the school custodian placed ant traps on the counter tops when school started, but it has not improved. 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.
SUPERVISORS NAME: Diana deLeon
LICENSING EVALUATOR NAME: Angelica Slaughter
LICENSING EVALUATOR SIGNATURE: DATE: 08/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/24/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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-GREENBERG
FACILITY NUMBER: 103808082
VISIT DATE: 08/24/2022
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LPA also reviewed a sample of staff files and observed they contained health screening and current documentation of completed Mandated Reporter Training. At least one person trained in CPR and pediatric First Aid is present when children are at the facility or at off-site activities.

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

This is an AM/PM half day program which operates on a traditional school year schedule. The morning session is 8:00 am to 11:00 am and the afternoon session is 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 Lead 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, 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 Lead Teacher Veronica Huerta.

SUPERVISORS NAME: Diana deLeon
LICENSING EVALUATOR NAME: Angelica Slaughter
LICENSING EVALUATOR SIGNATURE:

DATE: 08/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2022
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Document Has Been Signed on 08/24/2022 01:36 PM - It Cannot Be Edited


Created By: Angelica Slaughter On 08/24/2022 at 01:03 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-GREENBERG
FACILITY NUMBER: 103808082

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/24/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101238(a)
Buildings and Grounds
(a) The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPAs observation, the licensee did not comply with the section cited above in that the facility currently has an ant infestation, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 08/29/2022
Plan of Correction
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Lead Teacher will consult with school personnel about what can be done to eliminate the ant/pest infestation and will advise CCLD by the POC due date of 08/29/22.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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: 08/24/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/24/2022


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