153810191-9-7-2023-57-CC-TMAZ-CVFTXG-20230907150706

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 153810191
Report Date: 09/07/2023
Date Signed: 09/07/2023 03:07:12 PM

Document Has Been Signed on 09/07/2023 03:07 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 SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME:	CAL IVY PREP AT CSUB		FACILITY NUMBER:	153810191
ADMINISTRATOR:	MILLER, AMY		FACILITY TYPE:	830
ADDRESS:	9001 STOCKDALE HWY		TELEPHONE:	(661) 654-3165
CITY:	BAKERSFIELD	STATE: CA	ZIP CODE:	93311
CAPACITY:	18	CENSUS: 7	DATE:	09/07/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Danisha Maiden		TIME COMPLETED:	03:30 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On September 7, 2023, Licensing Program Analyst (LPA) Theresa Marquez conducted an unannounced Required 1 year inspection at CAL Ivy Prep CSUB infant program. LPA met with Directors, Darnisha Maiden and Amy Miller and toured the facility, indoors and outdoors. This is a full day program operating year round calendar 7:00 AM – 6:00 PM, Monday – Friday. The center provides lunch and AM/PM snacks. Lunch meals are prepared off site and menus are posted at least one week in advance where an authorized representative can view them. Transportation is not provided. Capacity and limitations as specified on the license are being maintained. The name of the childcare 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 4 infants 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. The facility had sufficient age appropriate furniture and equipment, including cribs, cots or mats, changing tables, and feeding chairs. Each crib, mat, or cot was occupied by only one infant at a time and cribs were free from all loose articles including blankets and pillows. There were no objects hanging above or attached to the crib. Infants are not swaddled in care. Staff physically check on sleeping infants every 15 minutes and documents any signs of distress which include but is not limited to: flushed skin color, increase in body temperature, restlessness, and labored breathing. For infants up to 12 months, documentation also includes sleeping position if it is other than on their back. Individual Infant Sleeping Plans were completed and in file for each infant up to 12 months of age. Infants up to 12 months of age are placed on their backs for sleeping. Staff-infant ratio requirements were being met while infants were sleeping. There was indoor and outdoor activity space for infants that was physically separate. Continued on LIC809-C

SUPERVISOR'S NAME: Luisa Gavoutian	TELEPHONE: (559) 650-7879
LICENSING EVALUATOR NAME: Theresa Marquez	TELEPHONE: (559) 341-7123
LICENSING EVALUATOR SIGNATURE:	DATE: 09/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/07/2023

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: CAL IVY PREP AT CSUB	FACILITY NUMBER: 153810191
	VISIT DATE: 09/07/2023

NARRATIVE

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There were no bodies of water, firearms and/or ammunition on the premises. Disinfectants, hazardous items and medications were inaccessible to children. No poisons were observed during the inspection. Furniture and equipment were in good condition, free of sharp, loose or pointed parts. 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, swings and slides have 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.
Solid waste storage containers had tight-fitting covers and were in good repair. Menus are posted at least one week in advance where an authorized representative can view them. The facility had one or more functioning carbon monoxide detectors that meet statutory requirements.

Drinking water is available both indoors and outdoors. Drinking water is provided by filtered drinking fountains and personal water bottles.

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, medical assessment, individual feeding plan, and Infant Needs and Services Plan.
LPA also 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. Staff records contained documentation of meeting qualification requirements. At least one person trained in CPR and pediatric First Aid is present when children are at the facility or at off-site activities.

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).

Director Maiden 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.

Continued on LIC809-C

SUPERVISOR'S NAME: Luisa Gavoutian	TELEPHONE: (559) 650-7879
LICENSING EVALUATOR NAME: Theresa Marquez	TELEPHONE: (559) 341-7123
LICENSING EVALUATOR SIGNATURE:	DATE: 09/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/07/2023

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 SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: CAL IVY PREP AT CSUB	FACILITY NUMBER: 153810191
	VISIT DATE: 09/07/2023

NARRATIVE

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Assembly Bill 2370, Chapter 676, Statutes of 2018 requires all Child Care Centers (CCCs) that are located in buildings constructed before January 1, 2010 to test their drinking water for lead contamination by January 1, 2023 and every 5 years thereafter. This facility has provided evidence of completed water testing for samples collected on December 16, 2022 and February 1, 2023 with no action level exceedances noted.

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/.
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 of the California Code of Regulations no deficiencies were observed today.

An exit interview was conducted with Darnisha Maiden and Amy Miller. LPA provided Maiden and Miller with a copy of the Facility Evaluation Report (LIC 809), Appeal Rights, and the Notice of Site Visit form (LIC 9213).

SUPERVISOR'S NAME: Luisa Gavoutian	TELEPHONE: (559) 650-7879
LICENSING EVALUATOR NAME: Theresa Marquez	TELEPHONE: (559) 341-7123
LICENSING EVALUATOR SIGNATURE:	DATE: 09/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/07/2023

LIC809 (FAS) - (06/04)

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