103808330-1-12-2023-04-CC-AGIN-CMZS7U-20230112123807

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 103808330
Report Date: 01/12/2023
Date Signed: 01/12/2023 12:38:21 PM

Document Has Been Signed on 01/12/2023 12:38 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:	FCEOC EARLY H.S.-JANE ADDAMS CDC		FACILITY NUMBER:	103808330
ADMINISTRATOR:	PADILLA, MARIA		FACILITY TYPE:	850
ADDRESS:	2117 W. MCKINLEY AVENUE		TELEPHONE:	(559) 263-1205
CITY:	FRESNO	STATE: CA	ZIP CODE:	93728
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 7	DATE:	01/12/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Cheryl Jones		TIME COMPLETED:	12:30 PM

NARRATIVE

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On 01/12/23 Licensing Program Analysts (LPA) Araceli Gibson and (LPA) Anita Tristan, conducted an unannounced annual inspection. LPA met with Director, Cheryl Jones. This facility has one preschool classroom. The program runs year- round 07/01/22 to 06/30/23 Monday through Friday from 7:30 PM to 5:30 PM with a census of 4 children. LPAs toured the facility, both indoors and outdoors to inspect areas accessible to children in care.

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. Playground equipment is in safe condition. The surface of the outdoor activity space is maintained in a safe condition and monitored for hazards. All toilets and handwashing facilities are in safe and sanitary operating condition. Floors in the facility are clean and safe. All kitchen, food preparation and storage areas are clean, free of litter/rubbish and free of 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. Drinking water is available both indoors and outdoors. Areas around high climbing equipment, swings and slides have cushioning material to absorb falls. The facility is free of flies, insects and rodents. Facility has one or more functioning carbon monoxide detectors that meet statutory requirements. Prior to working or volunteering in a licensed child care facility, all individuals subject to a criminal record review have received a criminal record clearance or exemption. Upon notification from the Department, the 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. Continue 809C

SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Araceli Gibson
LICENSING EVALUATOR SIGNATURE:	DATE: 01/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/12/2023

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 01/12/2023 12:38 PM - It Cannot Be Edited

Created By: Araceli Gibson On 01/12/2023 at 12:09 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: FCEOC EARLY H.S.-JANE ADDAMS CDC	FACILITY NUMBER: 103808330
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/12/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101215.1(b)

Child Care Center Director Qualifications and Duties

(b) All child care centers shall have a director. 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 Staff at this facility states she is the director however this has not been verified as director packet has not been submitted to CCLD which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 01/26/2023
	Plan of Correction
1 2 3 4	Staff agreed to submit a director packet reflecting licensing required qualifications and forms by plan of correction date 01/26/23

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:

Araceli Gibson

LICENSING EVALUATOR SIGNATURE:

DATE: 01/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/12/2023

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: FCEOC EARLY H.S.-JANE ADDAMS CDC	FACILITY NUMBER: 103808330
	VISIT DATE: 01/12/2023

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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. LPA addressed missing information pertaining to center director or fully-qualified teacher designated to act in the director’s absence has not been reported to the Department. LPA issued a Type B see 809D for further. Facility is maintaining signing children in/out of the facility by authorized representatives at the site. All children are under supervision, including visual supervision, of a teacher at all times while virtual learning format. Facility maintains a ratio of one teacher supervising no more than 12 children in care when in person learning is conducted. LPA Gibson reviewed a sample of children’s files and were observed to be complete. Emergency cards with contact information for authorized representative and or relatives or others who can assume responsibility for the child and medical assessment. LPA Gibson 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. Menus are posted at least one week in advance where an authorized representative can view them.

Incidental Medical Services (IMS) are currently not being provided. Licensee is aware that an IMS plan is required to be submitted to the licensing office if they provide any of these services. 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.

LPA and Licensee 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.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following deficiency is being cited: (see next page, 809 D) Licensee was provided a copy of their appeal rights.

SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Araceli Gibson
LICENSING EVALUATOR SIGNATURE:	DATE: 01/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/12/2023

LIC809 (FAS) - (06/04)

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