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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 203810223
Report Date: 08/28/2023
Date Signed: 08/28/2023 04:51:37 PM

Document Has Been Signed on 08/28/2023 04:51 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:MADISON STATE PRESCHOOLFACILITY NUMBER:
203810223
ADMINISTRATOR:NORA GUILLENFACILITY TYPE:
850
ADDRESS:109 STADIUM RDTELEPHONE:
(559) 675-4630
CITY:MADERASTATE: CAZIP CODE:
93637
CAPACITY: 24TOTAL ENROLLED CHILDREN: 11CENSUS: 10DATE:
08/28/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:10 PM
MET WITH:Rhiana Thornton TIME COMPLETED:
03:30 PM
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On 08/28/23 Licensing Program Analyst (LPA) Denisia Jimenez arrived at facility to conduct an unannounced Annual Required Inspection for the preschool license. LPA met with ECE Specialist, Rhiana Thorton and toured the facility. The facility consists of 1 preschool classroom. 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. LPA confirmed facility has a working telephone number of 559-675-4630. LPA observed 10 children in the classroom with 1 teacher and 2 Instructional Aides. Facility was operating within their ratio requirements. LPA observed all required postings. Staff are fingerprint cleared as a condition of employment through Madera Unified School District.

LPA observed the playground area utilized by children is surrounded by appropriate fencing and the outdoor surfaces are safe for the children. LPA observed the south side left exterior K-C classroom bottom wall has a piece of wood that is decaying and rotting. The west side exterior of K-C classroom exterior bottom wall has a piece of wood that is decaying and rotting. The east side exterior K-A classroom bottom right piece of wood is decaying and rotting. LPA also observed the chain link fence needs to be fixed, the east side bottom of the fence is loose and needs to get tightened. ECE Specialist stated she will submit a work order to get these items fixed. LPA observed that the outdoor equipment is age appropriate (2-5 years old) and in good condition. Shade is provided by a building overhang in the playground area with 2 mature trees around the playground. ECE Specialist stated that there are no bodies of water present in the facility, LPA did not observe any bodies of water. Furniture and equipment were inspected for good repair, free of sharp, loose, or pointed parts and all equipment appeared fine during the inspection. ECE Specialist stated that there are no weapons on the premises. The toilets and hand washing facilities are in safe and sanitary operating conditions.

Food menus were reviewed, the ECE Specialist stated they are posted at least one week in advance and posted for parents to see. Preschool children are provided with Breakfast and Lunch. Food is brought over from the central kitchen to the site cafeteria pre-packaged and children eat in their designated classrooms. All kitchen, food preparation, and storage areas are clean, free of litter, rubbish, and rodents/vermin. All food is protected from contamination. Children are provided with drinking water and paper cups. All storage containers for solid waste, including moveable bins, have tight fitting covers on and are in good repair. Facility has functioning smoke detector/carbon monoxide detector and a complete first aid kit.



(Continued on 809-C)
SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Denisia Jimenez
LICENSING EVALUATOR SIGNATURE: DATE: 08/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/28/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
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: MADISON STATE PRESCHOOL
FACILITY NUMBER: 203810223
VISIT DATE: 08/28/2023
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LPA reviewed 5 children’s files. Children’s Records were reviewed for completeness and inspection of required forms was made. LPA reviewed 3 staff files. All staff files contain the required transcripts/verification of experience/immunization records, and Health Screening Report. All staff have current Mandated Reporter Training certificates. At least one staff has a current CPR and First Aid certification. The ESE Specialist understands that there shall be at least one person, with valid CPR and First Aid certifications, on site at all times or present during off-site activities (field trips).
The ECE Specialist 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.

The ECE Specialist stated the facility does administer medication to children, however no children are taking any medication currently. Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. When any IMS is provided, an updated 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) 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-care-centers/

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For childcare center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1- CCP). LPA verified that the lead testing was completed in accordance with the Written Directives outlined in PIN 21-21.1-CCP. LPA referred the Director to the Department website for lead: www.cdss.ca.gov/inforesources/child-care-licensing/water-testing-information. This facility has provided evidence that their drinking fountain has been tested and has no exceedances.

LPA and the ECE Specialist 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.

(Continued on 809-C)

SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Denisia Jimenez
LICENSING EVALUATOR SIGNATURE:

DATE: 08/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2023
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: MADISON STATE PRESCHOOL
FACILITY NUMBER: 203810223
VISIT DATE: 08/28/2023
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LPA discussed Reporting Requirements as outlined in the regulations (Section 101212).

The ECE Specialist was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

Exit interview conducted and report was reviewed with ECE Specialist, Rhiana Thornton Appeal rights were provided.

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

This report shall be made available to the public upon request.

LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.

SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Denisia Jimenez
LICENSING EVALUATOR SIGNATURE:

DATE: 08/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2023
LIC809 (FAS) - (06/04)
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