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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 200406914
Report Date: 06/28/2022
Date Signed: 06/28/2022 09:46:10 AM

Document Has Been Signed on 06/28/2022 09:46 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
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:EASTON ARCOLA MIGRANT HEAD STARTFACILITY NUMBER:
200406914
ADMINISTRATOR:SANDOVAL, SYLVIAFACILITY TYPE:
850
ADDRESS:29551 AVENUE 8TELEPHONE:
(559) 673-0452
CITY:MADERASTATE: CAZIP CODE:
93637
CAPACITY: 67TOTAL ENROLLED CHILDREN: 19CENSUS: 16DATE:
06/28/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Patty AlmanzaTIME COMPLETED:
10:00 AM
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On 06/28/22, Licensing Program Analyst (LPA) Angelica Slaughter conducted a Licensee Initiated Case Management inspection at the facility and met with CAPMC Health Service Content Specialist, Patty Almanza. The purpose of the visit was to inspect a newly installed playground structure at the facility. The new play structure is in the same outside activity area that has been licensed for preschool children. The play structure was professionally installed, and is properly anchored into the ground. There is wood chips underneath the structure that adequately covers the fall zones. There is a large canopy that covers the entire play structure that provides adequate shade. The facility provided literature that shows the new play structure equipment is designed for children ages 2-5 years old. The play structure has the age appropriate sticker affixed to it. There is also a supervision sign that is placed to the East side of the play structure that indicates the play structure is for children 2-5 years of age. LPA advised Ms. Almanza that prior to allowing children to use the play structure, the wood chips should be raked and sorted through to ensure there are no hard dirt rocks or other items that can cause potential harm to children in care. Once this process has been completed, effective immediately, the facility may begin using the new structure for preschool children.

Per Chapter 1, Division 12, Title 22 of the California Code of Regulations no deficiencies are observed today.

Exit interview was conducted with Patty Almanza. Ms. Almanza was provided a copy of the Facility Evaluation Report (LIC 809), appeal rights, and the Notice of Site Visit form (LIC 9213). The LIC 809 is required to remain in the facility for public review and the LIC 9213 is required to be posted for 30 days.
SUPERVISORS NAME: Diana deLeon
LICENSING EVALUATOR NAME: Angelica Slaughter
LICENSING EVALUATOR SIGNATURE: DATE: 06/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/28/2022
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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