203810223-8-8-2022-04-CC-CBRN-CH4PWN-20220808114102

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 203810223
Report Date: 08/08/2022
Date Signed: 08/08/2022 11:41:12 AM

Document Has Been Signed on 08/08/2022 11:41 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:	MADISON STATE PRESCHOOL		FACILITY NUMBER:	203810223
ADMINISTRATOR:	NORA GUILLEN		FACILITY TYPE:	850
ADDRESS:	109 STADIUM RD		TELEPHONE:	(559) 675-4630
CITY:	MADERA	STATE: CA	ZIP CODE:	93637
CAPACITY: 24	TOTAL ENROLLED CHILDREN: 24	CENSUS: 0	DATE:	08/08/2022
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Brenda Naranjo		TIME COMPLETED:	12:00 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 August 8, 2022, Licensing Program Analyst (LPA) C Brannon conducted an announced prelicensing inspection and met with Brenda Naranjo, ECE Specialist. LPA explained the reason of the inspection and a tour of the center was conducted both inside and outside. The center is located at Madison Elementary school. This is a new facility and the applicant is requesting 24 preschool, ages 2-6 years old. This program will operate traditional school schedule; August through June. This facility will provide part time options from 8:00 AM to 11:00 AM and 12:00 PM to 3:00 PM, Monday through Friday. This program will operate in one classroom, the Preschool Classroom. Licensee is Madera Unified School District. Parents will bring their children into the classroom and sign them in, staff conduct daily health checks and conduct a risk assessment. Brenda Naranjo, ECE Specialist, stated that it is optional for staff and children use masks while indoors. LPA reminded Brenda Naranjo that the Public Health Department and CDC strongly recommends for staff and children to wear face masks. During today's inspection, LPA provided PIN 22-20-CCP, LIC 9275 and LIC 9276 in regards to Lead Testing.. Brenda Naranjo stated that the center will provide breakfast and lunch. The meals are provided by Madison Elementary. Ill children will be isolated in the nurse’s office and utilize the bathroom located in the nurse’s office. The classrooms were observed to be clean and free of toxins. LPA observed that the furniture and equipment appeared to be safe and in good condition. There are enough tables, chairs, cots, and plenty of toys for children to play. LPA also reminded Brenda Naranjo not to store anything on top of high bookcases/storage cabinets that could potentially fall on children. There is a working carbon monoxide detector inside the classroom. CONTINUED ON FOLLOWING PAGE

SUPERVISORS NAME: Michael Duarte
LICENSING EVALUATOR NAME: Cynthia Brannon
LICENSING EVALUATOR SIGNATURE:	DATE: 08/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2022

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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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: MADISON STATE PRESCHOOL	FACILITY NUMBER: 203810223
	VISIT DATE: 08/08/2022

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LPA reviewed with Brenda Naranjo, that any future changes to the classroom are required to ensure that furniture does not tip over on to children, the furniture are to be anchored or situated that tipping does not occur. Classroom changes of furniture shall be situated that 100% visual supervision is always provided to children in care. Per Brenda Naranjo, bathroom procedures when taking children to the restroom shall require staff to stand at the door to assist a child if needed.

Room measurements were taken and reviewed with ECE Specialist, Brenda Naranjo. The total inside preschool area measured to an approximate 1034 square feet which will accommodate the requested capacity of 24 preschool. There is adequate storage space available for children's belongings in the classroom. Brenda Naranjo understands that children's equipment needs to match the licensed capacity. Toys and equipment appear to be age appropriate. There is a total of 2 toilets and 2 sinks/hand washing fixtures which will accommodate the requested capacity of 24 preschool children. The chidlren's bathroom is located in the classroom. The restroom has one sink and one sink located in the classroom. These sinks are not to be used for food preparation.

Licensee is providing the following to provide accessible drinking water to children in care: For inside drinking water, licensee is providing disposable cup dispenser with disposable cups. For the outside drinking water, licensee is providing an igloo with disposable cup dispenser with disposable cups.

The approximate outside square footage for the preschool area is 8658 which will accommodate requested capacity of 24 Preschool Children. This facility is sharing the outdoor play yard with Madison kindergarten class. An outdoor waiver has been received and requested. A schedule was provided and will be followed to prevent commingling.

LPA observed age appropriate toys, a bike path and climbing structure. Applicant is using wood chip to cushion fall zones. There is shade available where children can rest and get water. Licensee has one permanent shade structure with cushioning wrapped around the metal poles. The climbing structure has an age appropriate sticker for age 2 to 5-year-old. LPA reminded Brenda Naranjo, ECE Specialist, to provide adequate supervision at all times. There is a curved tube component on the climbing structure. Per Brenda Naranjo, staff will be stationed at the end of the tunnel to be able to provide 100% visual supervision as required.
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SUPERVISORS NAME: Michael Duarte
LICENSING EVALUATOR NAME: Cynthia Brannon
LICENSING EVALUATOR SIGNATURE:	DATE: 08/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2022

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: MADISON STATE PRESCHOOL	FACILITY NUMBER: 203810223
	VISIT DATE: 08/08/2022

NARRATIVE

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A fire clearance of 48 preschool children was approved and granted by the City of Madera Fire Department on July7, 2022.

This facility plans to provide Incidental Medical Services – IMS. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. A Plan of Operation that includes IMS must be submitted to the Department. 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 The medication for the children will be kept in the classroom in an inaccessible locked cabinet.

Brenda Naranjo was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, 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.

This facility does not provide care to infants. LPA discussed the safe sleep regulations with Brenda Naranjo 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 ECE Specialist, Brenda Naranjo, 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.

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SUPERVISORS NAME: Michael Duarte
LICENSING EVALUATOR NAME: Cynthia Brannon
LICENSING EVALUATOR SIGNATURE:	DATE: 08/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2022

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: MADISON STATE PRESCHOOL	FACILITY NUMBER: 203810223
	VISIT DATE: 08/08/2022

NARRATIVE

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The following items must be completed prior to issuing a license by 9/8/22 or sooner
Inside Daycare:
1) Anchor shelving units and bookshelves in the classrooms
2) Anchor the play kitchen components. ·

Outside Play Area:
1) Remove all four trikes with missing rubber grip handle bar covers.
2) The kindergarten exterior wall faces the outside play yard. The exterior wall has a missing/exposed wooded area.

The climbing structure has metal components with high traffic areas missing paint. Licensee shall ensure that the metal components are painted to ensure this wear does not get worse. Replace the cushioning around the shade structure metal poles. The cushioning has exposed foam.
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Pending a final file review and completion of above items, a recommendation will be made to license the above facility for the requested capacity of 24 preschool children.

LPA reviewed with Brenda Naranjo, the LIC 311A, Records To Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted.
The following documents should be posted at the facility:
* PUB 269- Child passenger restraint systems poster 101225(f) Transportation
* Pub 393- Notification of Parents Rights 101218.1(c) Admission Procedures
* License 101160(a) License
* Menus 101227(a)(6) Food Services
* LIC 613A- Personal Rights form 101223(b)(2) Personal Rights
* LIC 610- Disaster Plan 101174(a)
* LIC 9148- Earthquake Preparedness Checklist 101174(b)
* Activity Schedule
* Lead Poisoning brochure

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SUPERVISORS NAME: Michael Duarte
LICENSING EVALUATOR NAME: Cynthia Brannon
LICENSING EVALUATOR SIGNATURE:	DATE: 08/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2022

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: MADISON STATE PRESCHOOL	FACILITY NUMBER: 203810223
	VISIT DATE: 08/08/2022

NARRATIVE

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Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.

To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

Exit interview conducted and report was reviewed with Brenda Naranjo.

A COPY OF THIS REPORT IS TO REMAIN IN THE FACILITY FOR PUBLIC REVIEW.
THIS REPORT SHALL BE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
To order forms, etc. visit our website at www.ccld.ca.gov

SUPERVISORS NAME: Michael Duarte
LICENSING EVALUATOR NAME: Cynthia Brannon
LICENSING EVALUATOR SIGNATURE:	DATE: 08/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2022

LIC809 (FAS) - (06/04)

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