203801368-3-16-2023-04-CC-DJIZ-CPYUP3-20230316154453

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 203801368
Report Date: 03/16/2023
Date Signed: 03/16/2023 03:45:00 PM

Document Has Been Signed on 03/16/2023 03:45 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, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME:	PIXIE LAND		FACILITY NUMBER:	203801368
ADMINISTRATOR:	JENKINS, TINA		FACILITY TYPE:	840
ADDRESS:	3290 SUNSET		TELEPHONE:	(559) 673-2223
CITY:	MADERA	STATE: CA	ZIP CODE:	93637
CAPACITY: 47	TOTAL ENROLLED CHILDREN: 47	CENSUS: 0	DATE:	03/16/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	Tina Jenkins		TIME COMPLETED:	01:00 PM

NARRATIVE

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On 03/16/2023 Licensing Program Analysts (LPAs) Denisia Jimenez and Nancy Her, conducted an unannounced Annual Required Inspection for the school age license. LPAs met with Director, Tina Jenkins, and toured the facility indoors and outdoors. Days and hours of operation are Monday thru Friday from 6:00AM to 6:00 PM.

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.

Furniture and equipment are in good condition, free of sharp, loose or pointed parts. Playground equipment is in safe condition, free of sharp, loose or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. All toilets and handwashing facilities are in safe and sanitary operating condition. Floors in the facility are clean and safe. All kitchen, food preparation and storage areas are clean, free of litter/rubbish and free of rodents/vermin. 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. 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.

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 09/24/2023 with no action level exceedances noted.

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.

SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Denisia Jimenez
LICENSING EVALUATOR SIGNATURE:	DATE: 03/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2023

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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Document Has Been Signed on 03/16/2023 03:45 PM - It Cannot Be Edited

Created By: Denisia Jimenez On 03/16/2023 at 02:16 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: PIXIE LAND	FACILITY NUMBER: 203801368
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/16/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above. Several employees did not have the mandated reporter training completed which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 03/30/2023
	Plan of Correction
1 2 3 4	Employees will complete the mandated reporter training and submit evidence to Fresno Community Care Licensing by 03/30/23.

Type B

Section Cited

CCR

101529.1(b)

Sign In and Sign Out

(b) Center staff shall sign in a school-age child who arrives at the center on his/her own. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above. Several children were not signed into the facility on several days which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 03/30/2023
	Plan of Correction
1 2 3 4	Director will submit two weeks of sign in/out logs to Fresno Community Care Licensing by 03/30/2023.

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:

Denisia Jimenez

LICENSING EVALUATOR SIGNATURE:

DATE: 03/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2023

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

FACILITY NAME: PIXIE LAND	FACILITY NUMBER: 203801368
	VISIT DATE: 03/16/2023

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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 offsite 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. During today’s inspection LPAs observed several children were not signed in/out on the sign in/out sheets. The person who signs the child in/out of the facility shall use their full legal signature and record the time of day. All children are under supervision, including visual supervision, of a teacher at all times. 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. LPAs reviewed a sample of staff files and observed files were missing immunization records for measles and staff members did not have current documentation of completed mandated reporter training. Staff files were complete with health screening and immunization records for influenza and pertussis. Menus are posted at least one week in advance where an authorized representative can view them.

Incidental Medical Services (IMS) are currently being provided. 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 Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

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.

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.

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, the following deficiencies are being cited: (see next page, 809 D)

Exit interview conducted and report was reviewed with the facility representative Tina Jenkins.

A notice of site visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Denisia Jimenez
LICENSING EVALUATOR SIGNATURE:	DATE: 03/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2023

LIC809 (FAS) - (06/04)

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