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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153808574
Report Date: 09/08/2021
Date Signed: 09/09/2021 01:50:17 PM

Document Has Been Signed on 09/09/2021 01:50 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:WILLOW CHILD DEVELOPMENT CENTERFACILITY NUMBER:
153808574
ADMINISTRATOR:JONES, NIKOLAFACILITY TYPE:
850
ADDRESS:401 WILLOW DRIVETELEPHONE:
(661) 336-5236
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93308
CAPACITY: 56TOTAL ENROLLED CHILDREN: 56CENSUS: 16DATE:
09/08/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:05 PM
MET WITH:Nikola JonesTIME COMPLETED:
03:30 PM
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On 9/8/21 an unannounced annual inspection was conducted today by Licensing Program Analyst, (LPA) Caroline Harris. LPA met with Site Director II, Nikola Jones and toured the facility, both indoors and outdoors. The LPA observed all required licensing forms to be posted in a visible location for authorized representatives to view them. A census was taken and there were sixteen day care children present. This facility runs from 8:00 AM to 4:00 PM Monday threw Friday. Breakfast, lunch and a PM snack are prepared at the facility and are served individually to the children in the classrooms. All kitchen, food prep, and storage areas are clean, free of litter, rubbish, and rodents/vermin. All food is protected from contamination, and contaminated food is discarded immediately. Solid waste storage vessels, including moveable bins, have tight-fitting covers on, are in good repair. All foods/beverages capable of rapid spoiling are stored in covered containers at 45 (F) or less. Menus are posted at least one week in advance, where an authorized representative can view them. Firearms/weapons or ammunition are not allowed or stored on the premises. 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. 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. All materials and surfaces accessible to children are toxic free. All toilets, hand washing, and bathing facilities are in safe and sanitary operating conditions. All floors are clean and safe. Furniture and equipment are in good condition, free of sharp, loose, or pointed parts. There is a working fire extinguisher, smoke detector, carbon monoxide indicator, and adequate heating and ventilation for safety and comfort. The licensee has a complete first aid kit, including bandages, scissor, thermometer, gloves and a first aid manual. Uncontaminated drinking water is available both indoors and outdoors. Playground equipment is in good condition, free of sharp, loose, or pointed parts. Outdoor activity space surface is maintained in a safe condition and is free of hazards. Areas around high climbing equipment, swings, and slides have cushioning material to absorb falls. The facility is currently not using the play structures for the children. There were no bodies of water on site.
SUPERVISORS NAME: Alice Juarez
LICENSING EVALUATOR NAME: Caroline Harris
LICENSING EVALUATOR SIGNATURE: DATE: 09/08/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/08/2021
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
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: WILLOW CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 153808574
VISIT DATE: 09/08/2021
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The facility representative was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated. There are no excluded individuals present at this facility. Licensee is aware that upon notice from the Department, any excluded individual must be immediately removed from the facility and prevented from returning to the center or having contact with children in care. The licensee shall comply with the notice. Staff records contain appropriate, documentation of education credits. At least one person is to be trained in CPR and Pediatric first-aid and shall be present when children are at the facility or at off-site activities. This facility does have one person trained in CPR and first aid. Staff records contain documentation of immunizations against pertussis, measles and influenza for staff. LPA reviewed with Ms. Jones the Mandated Child Abuse Reporter Training (AB 1207), which all staff have completed. Ms. Jones is aware that the Mandated Reporter Training is required to be updated every two years. The LPA and licensee discussed the Community Care Licensing website: www.ccld.ca.gov. which provides access to Provider Information Notifications (PINS), Quarterly Updates that inform licensees of new legislation and regulations, training's, and Licensing forms and updated information. The licensee was also advised that it is her responsibility to stay current with regulations. 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, is responsible for the child, uses their full legal signature and records the time of day. Child's admission agreement is available for review. The LPA reviewed seven children’s files. All required licensing documents were observed in each of the children’s files. Licensee also maintains documentation of immunizations for the children. Incidental Medical Services (IMS) policy was discussed. This facility provides Incidental Medical Services (IMS), however does not have any children enrolled at this time who require medications. The facility does have a safe place inaccessible to children to store medications.

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations no deficiencies are observed today. An exit interview was conducted and a copy of this report was provided and reviewed with Nikola Jones. This report shall be made available to the public upon request. The LIC 9213 Notice Of Site Visit form was given to Ms. Jones and must remain posted for 30 days.



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.
SUPERVISORS NAME: Alice Juarez
LICENSING EVALUATOR NAME: Caroline Harris
LICENSING EVALUATOR SIGNATURE:

DATE: 09/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2021
LIC809 (FAS) - (06/04)
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