103810257-2-13-2025-04-CC-MHEA-DDUUTQ-20250213145219

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 103810257
Report Date: 02/13/2025
Date Signed: 02/13/2025 02:53:40 PM

Document Has Been Signed on 02/13/2025 02:53 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:	INCLUSION LEARNING CENTER-CLOVIS HILLS CHURCH		FACILITY NUMBER:	103810257
ADMINISTRATOR/ DIRECTOR:	MONICA PETERSON		FACILITY TYPE:	860
ADDRESS:	10590 N WILLOW AVE		TELEPHONE:	(209) 329-6792
CITY:	CLOVIS	STATE: CA	ZIP CODE:	93619
CAPACITY: 15	TOTAL ENROLLED CHILDREN: 13	CENSUS: 5	DATE:	02/13/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	08:52 AM
MET WITH:	Elizabed Gonzalez		TIME VISIT/ INSPECTION COMPLETED:	03:05 PM

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On February 13, 2025, Licensing Program Analyst (LPA) Miguel Herrera conducted an unannounced Annual Required Inspection and was met by Director, Elizabed Gonzalez. This program operates year round Monday through Friday with full day and half day options. Full day is from 7:00 am – 3:30 pm. The AM session is from 7:00 am – 11:00 am. The PM session is from 11:30 am – 3:30 pm. This program operates in Classroom 212.

LPA toured the facility indoors and outdoors, and a census was taken and there were 5 children present with qualified staff. The LPA observed all required licensing forms to be posted in a visible location for authorized representatives to view them. 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 twelve children in attendance. Capacity and limitations as specified on the license are being maintained.

The facility has an electronic sign in/out system for the usage of parents and/or authorized representatives. LPA Herrera reminded Director Gonzalez to ensure that the electronic sign in/out system documents a full legal signature and a record of the time of day. 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. The LPA did not observe disinfectants, cleaning solutions and other dangerous items to be accessible to children. There were no poisons observed on the premises accessible to children. Licensee is aware that poisons are required to be locked and inaccessible to children.

During the inspection, LPA observed furniture and equipment in good condition, free of sharp, loose, or pointed parts. The facility has sufficient age-appropriate furniture, and equipment. LPA Herrera advised Director Gonzalez to have staff conduct frequent safety inspections of the outdoor play structure and to check for any loose parts, cracks, and hazards. LPA also advised Director Gonzalez to continue to replenish areas around the play structure with wood chips as needed. Director Gonzalez is aware of child safety around the play structure and assumes all responsibility. Director Gonzalez understands that children must be always supervised while using the play structure. Continued on 809-C.

SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Miguel Herrera
LICENSING EVALUATOR SIGNATURE:	DATE: 02/13/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2025

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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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: INCLUSION LEARNING CENTER-CLOVIS HILLS CHURCH	FACILITY NUMBER: 103810257
	VISIT DATE: 02/13/2025

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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. Per Director Gonzalez the facility is using the kitchen faucet as a source of drinking water and to prepare snacks. During records review LPA Herrera did not see documentation on file for water lead testing. LPA Herrera informed Director Gonzalez that child care center licenses issued after July 1, 2022, shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700. Director Gonzalez stated that the facility will ensure to test their water for lead and provide the report results to CCLD Fresno. In the meantime, Director Gonzalez stated that the facility will provide bottled water to children in care and use bottled water for kitchen prep. All kitchen, food preparation and storage areas are clean. All foods/beverages capable of rapid spoiling are stored in covered containers. Menus are posted at least one week in advance where an authorized representative can view them.

The facility is free of flies, insects, and rodents. Solid waste storage containers have tight-fitting covers and are in good repair. 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. LPA Herrera discussed Fire drills procedures with Director Gonzalez. Director Gonzalez is aware that fire drills should be conducted and documented with the date, time and how many children present, every six months.

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 off-site activities. 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. LPA reviewed a sample of children’s files and observed files to be complete with immunization and health records. Children files also had contact information for authorized representative and or relatives or others who can assume responsibility for the child. LPA reviewed a sample of staff files and observed files were complete with health screening, immunization records for influenza, pertussis and measles. LPA Herrera observed that staff files had current 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). Continued on 809-C.

SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Miguel Herrera
LICENSING EVALUATOR SIGNATURE:	DATE: 02/13/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2025

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: INCLUSION LEARNING CENTER-CLOVIS HILLS CHURCH	FACILITY NUMBER: 103810257
	VISIT DATE: 02/13/2025

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Director Gonzalez was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

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 Director Gonzalez to the Department website for lead: www.cdss.ca.gov/inforesources/child-care-licensing/water-testing-information.

LPA discussed safe sleep regulations with Director 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 Director 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.

Incidental Medical Services (IMS) are currently not being provided. Incidental Medical Services (IMS) policy was discussed. Licensee is aware that an IMS plan is required to be submitted to the licensing office if they provide any of these services. 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/. Continued on 809-C.

SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Miguel Herrera
LICENSING EVALUATOR SIGNATURE:	DATE: 02/13/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2025

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: INCLUSION LEARNING CENTER-CLOVIS HILLS CHURCH	FACILITY NUMBER: 103810257
	VISIT DATE: 02/13/2025

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Director Elizabed Gonzalez 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 Director Elizabed Gonzalez. Appeal rights were provided. Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, there is one deficiency being cited during today’s inspection (see 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: 02/13/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2025

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 02/13/2025 02:53 PM - It Cannot Be Edited

Created By: Miguel Herrera On 02/13/2025 at 01:51 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: INCLUSION LEARNING CENTER-CLOVIS HILLS CHURCH	FACILITY NUMBER: 103810257
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/13/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

101700(b)

(b) All licensed Child Care Centers operating in buildings constructed before January 1, 2010, shall test their water for lead pursuant to these written directives. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	During the inspection Director Gonzalez stated that the facility uses the water from the church's kitchen to drink water and clean/prep snacks such as fruits and vegetables. During file review LPA Herrera observed that the facility had not conducted a water lead test, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 02/27/2025
	Plan of Correction
1 2 3 4	Per licensee, she will schedule for the required lead testing to be conducted by an entity that has been approved by the Department before 03/13/2025. Licensee shall provide a copy of scheduled testing to the Fresno Community Care Licensing Regional Office by 02/27/2025.

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: 02/13/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2025

LIC809 (FAS) - (06/04)

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