103808802-10-14-2024-04-CC-MHEA-DA2KUP-20241014081303

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 103808802
Report Date: 10/11/2024
Date Signed: 10/14/2024 08:14:15 AM

Document Has Been Signed on 10/14/2024 08:14 AM - 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-HAMILTON		FACILITY NUMBER:	103808802
ADMINISTRATOR/ DIRECTOR:	MATHIES, DEANNA		FACILITY TYPE:	850
ADDRESS:	102 E. CLINTON		TELEPHONE:	(559) 457-3690
CITY:	FRESNO	STATE: CA	ZIP CODE:	93704
CAPACITY: 24	TOTAL ENROLLED CHILDREN: 9	CENSUS: 8	DATE:	10/11/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	12:45 PM
MET WITH:	Debra Johnson		TIME VISIT/ INSPECTION COMPLETED:	03:45 PM

NARRATIVE

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On 10/11/24 Licensing Program Analyst (LPA) Miguel Herrera, conducted an unannounced annual inspection. LPA met with Lead Teacher, Debra Johnson. This facility is housed on the Hamilton K-8 school campus in Room 23. The facility operates on a traditional school year schedule with a half-day AM/PM programs. Days and hours of operation are Monday-Friday from 7:55 AM – 10:55 AM (AM session), and 11:30 AM - 2:30 PM (PM session). Today's census count was 8 children present in the PM session.

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. Playground, furniture and equipment are in safe condition, free of sharp, loose or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and monitored for hazards. All toilets and hand washing facilities are in safe and sanitary operating condition. Floors in the facility are clean and safe. Breakfast and Lunch is served in the cafeteria but children eat in the classroom. Menus are posted at least one week in advance where an authorized representative can view them. 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. The facility tested their water (used for drinking and food preparation) for lead contamination and sample results indicated lead levels to be under exceedance levels. 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. As a condition of employment for is for all staff to have a fingerprint clearance through Fresno Unified School District 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.

Continued on 809-C.

SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Miguel Herrera
LICENSING EVALUATOR SIGNATURE:	DATE: 10/11/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2024

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 10/14/2024 08:14 AM - It Cannot Be Edited

Created By: Miguel Herrera On 10/11/2024 at 02:21 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-HAMILTON	FACILITY NUMBER: 103808802
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/11/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101216(g)(1)

Personnel Requirements

(1) Except as specified in (3) below, good physical health shall be verified by a health screening, including a test for tuberculosis, performed by or under the supervision of a physician not more than one year prior to or seven days after employment or licensure. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on interview and records review, the licensee did not comply with the section cited above, staff #2 and staff #3 did not have the LIC 503 - Health Screening Report or a physcial on file, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 10/25/2024
	Plan of Correction
1 2 3 4	Lead Teacher stated she will obtain copies of completed LIC 503 - Health Screening Reports for the two staff files and provide documentation to LPA by POC due date.

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:

Miguel Herrera

LICENSING EVALUATOR SIGNATURE:

DATE: 10/11/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2024

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-HAMILTON	FACILITY NUMBER: 103808802
	VISIT DATE: 10/11/2024

NARRATIVE

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The facility has a complete first aid kit, including bandages, scissor, thermometer, gloves and a first aid manual. All toilets and hand washing facilities are in safe and sanitary operating condition. The facility has one or more functioning carbon monoxide detectors that meet the statutory requirements. There is a working fire extinguisher 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. The person who signs the child in/out of the facility shall use their full legal signature and record the time of day.

At least one person trained in CPR and Pediatric First Aid is present when children are at the facility or at offsite activities. The name of the child care center director or fully qualified teacher designated to act in the director’s absence has been reported to the Department. Facility maintains a ratio of one teacher supervising no more than 12 children in care. 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 2 out of 3 staff files to be missing a health screening report. Furthermore, staff #3’s MMR immunization was not on file. All staff had documentation of completed mandated reporter training.

LPA discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to resources such as forms, regulations Provider Information Notices (PINs), and Quarterly Updates.

LPA discussed Reporting Requirements as outlined in the regulations (Section 101212).

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). LPA verified that the lead testing was completed in accordance with the Written Directives outlined in PIN 21-21.1-CCP. LPA referred the Lead Teacher to the Department website for lead: www.cdss.ca.gov/inforesources/child-care-licensing/water-testing-information.

To be continued on 809-C.

SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Miguel Herrera
LICENSING EVALUATOR SIGNATURE:	DATE: 10/11/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2024

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-HAMILTON	FACILITY NUMBER: 103808802
	VISIT DATE: 10/11/2024

NARRATIVE

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LPA discussed safe sleep regulations with Lead Teacher 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. LPA also informed the Lead Teacher 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.

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 PIN 22-02-CCP. 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-carecenters/.

The Lead Teacher 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.

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.

Exit interview conducted and report was reviewed with Lead Teacher Debra Johnson. Appeal rights were provided. Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, the following deficiency is being cited: (see next page, LIC. 809-D). This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.

SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Miguel Herrera
LICENSING EVALUATOR SIGNATURE:	DATE: 10/11/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2024

LIC809 (FAS) - (06/04)

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