203808549-11-18-2021-04-CC-CBRN-C8GTRY-20211105145818

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 203808549
Report Date: 11/05/2021
Date Signed: 11/18/2021 08:41:32 AM

Document Has Been Signed on 11/18/2021 08:41 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:	MIS ANGELITOS MIGRANT HEAD START CENTER		FACILITY NUMBER:	203808549
ADMINISTRATOR:	LUGO, LOURDES		FACILITY TYPE:	850
ADDRESS:	75 E. ADELL STREET		TELEPHONE:	(559) 673-2252
CITY:	MADERA	STATE: CA	ZIP CODE:	93638
CAPACITY: 52	TOTAL ENROLLED CHILDREN: 52	CENSUS: 27	DATE:	11/05/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	07:45 AM
MET WITH:	Rosalva Romero		TIME COMPLETED:	04:00 PM

NARRATIVE

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On November 5, 2021, Licensing Program Analyst (LPA) Brannon, conducted an unannounced Annual Required Inspection for the preschool license. LPA met with Center Director, Rosalva Romero, and toured the facility indoors and outdoors. Days and hours of operation are Monday through Friday, 8:00 AM to 4:00 PM. Director verified facility phone number is (559) 673-2564.

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. Solid waste storage containers have tight-fitting covers and are in good repair. Drinking water is available both indoors and outdoors. For the outside, licensee is utilizing igloos with disposable cup dispensers and disposable cups. Areas around high climbing equipment have cushioning material to absorb falls. Licensee is utilizing wood chip for cushioning in both outside play yards and has permanent shade structures. The facility is free of flies, insects and rodents. Facility has one or more functioning carbon monoxide detectors that meet statutory requirements. During today’s inspection, LPA observed staff and some preschool children wearing face masks. Children were encouraged but not forced to wear their face masks.

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SUPERVISORS NAME: Michael Duarte
LICENSING EVALUATOR NAME: Cynthia Brannon
LICENSING EVALUATOR SIGNATURE:	DATE: 11/05/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/05/2021

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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Document Has Been Signed on 11/18/2021 08:41 AM - It Cannot Be Edited

Created By: Cynthia Brannon On 11/05/2021 at 12:55 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: MIS ANGELITOS MIGRANT HEAD START CENTER	FACILITY NUMBER: 203808549
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 11/05/2021

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101227(a)(19)

Food Service

(19) All food shall be protected against contamination. Contaminated food shall be discarded immediately. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based upon LPA’s observation, the licensee did not comply with the section cited above. On 11/3/21, LPA conducted an inspection and reviewed with Center Director and Cook the need to dispose or keep open bags of food in containers or zip lock bags to deter insects and vermin from entering into the facility. LPA was informed that facility does have zip lock bags on site. During today’s inspection, LPA found open bags of food. This poses a potential health, safety or personal rights risk to persons in care. .
	POC Due Date: 11/05/2021
	Plan of Correction
1 2 3 4	Center Director had the cook dispose of the open bags of food during today's inspection. Area Manager, Ms. A Martinez, stated that she will review with nutritionist about the requirement of keeping open bags of food in a container or zip lock bag to assist in keeping vermin out of the facility.

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:

Michael Duarte

LICENSING EVALUATOR NAME:

Cynthia Brannon

LICENSING EVALUATOR SIGNATURE:

DATE: 11/05/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/05/2021

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: MIS ANGELITOS MIGRANT HEAD START CENTER	FACILITY NUMBER: 203808549
	VISIT DATE: 11/05/2021

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Center Director, Rosalva Romero, 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. Upon notification from the Department, the licensee will comply and act immediately to terminate the employment of, remove from the facility or bar from entering the facility for any person it is deemed necessary while the Department considers granting or denying an exemption.

During today’s inspection, LPA observed that the two climbing structures did not have the age appropriate stickers. LPA observed children’s bathrooms were being utilized for storage. LPA observed a tall roll of paper, 6 small empty boxes, brooms and dust bins and small empty plastic containers. Children's bathrooms are not to be used for storage. LPA observed corner shelving unit that was not anchored and shelving units that can be tipped over by a child. LPA provided a copy of Building and Grounds, section 101238(d)(1) and Personal Rights, section 101223(a)(1) regulations to Center Director during today's inspection. LPA issued Technical Violations for these items.

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. Mis Angelitos Migrant Head Start Center director or fully qualified teacher designated to act in the director’s absence has been reported to the Department.

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.

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SUPERVISORS NAME: Michael Duarte
LICENSING EVALUATOR NAME: Cynthia Brannon
LICENSING EVALUATOR SIGNATURE:	DATE: 11/05/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/05/2021

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: MIS ANGELITOS MIGRANT HEAD START CENTER	FACILITY NUMBER: 203808549
	VISIT DATE: 11/05/2021

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LPA 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. Menus are posted at least one week in advance where an authorized representative can view them. This facility conducts and documents monthly fire drills. During today’s inspection, LPA requested an updated LIC 309 – Administrative Organization. The form in file is from 2012. LPA reviewed this form with Area Manager Angela Martinez. LPA pointed out the term expiration dates listed for the officers. This form reflects expired term dates for officers listed. An updated form will be sent to the Fresno Regional office.

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 t: http://www.ada.gov/childqanda.htm

Currently, licensee does have an infant program. LPA discussed the safe sleep regulations with center director and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed Center 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.

LPA and Center Director 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.

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SUPERVISORS NAME: Michael Duarte
LICENSING EVALUATOR NAME: Cynthia Brannon
LICENSING EVALUATOR SIGNATURE:	DATE: 11/05/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/05/2021

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: MIS ANGELITOS MIGRANT HEAD START CENTER	FACILITY NUMBER: 203808549
	VISIT DATE: 11/05/2021

NARRATIVE

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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.

The following documents should be posted at the facility:
Ø PUB 269 – child passenger restraint systems poster
Ø PUB 393 – Notification of Parents Rights
Ø License
Ø Menus
Ø LIC 613A – Personal Rights form
Ø LIC 610 – Disaster Plan
Ø LIC 9148 – Earthquake Preparedness Checklist

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following deficiency is being cited: (see next page, 809 D). Licensee was provided a copy of their appeal rights.

Exit interview conducted and report was reviewed with Center Director, Rosalva Romero. This report shall be made available to the public upon request. A notice of site visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Michael Duarte
LICENSING EVALUATOR NAME: Cynthia Brannon
LICENSING EVALUATOR SIGNATURE:	DATE: 11/05/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/05/2021

LIC809 (FAS) - (06/04)

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