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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 243808251
Report Date: 04/14/2022
Date Signed: 05/06/2022 12:36:57 PM

Document Has Been Signed on 05/06/2022 12:36 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
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:SAN LUIS HEAD STARTFACILITY NUMBER:
243808251
ADMINISTRATOR:FLORES, MELANIEFACILITY TYPE:
850
ADDRESS:129 7TH STREETTELEPHONE:
(209) 827-5691
CITY:LOS BANOSSTATE: CAZIP CODE:
93635
CAPACITY: 60TOTAL ENROLLED CHILDREN: 60CENSUS: 22DATE:
04/14/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Misty MendozaTIME COMPLETED:
12:30 PM
NARRATIVE
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On April 14, 2022, Licensing Program Analyst (LPA) Brannon and Licensing Program Manager (LPM) Moctezuma met with Site Supervisor, Misty Mendoza. Licensee is requesting a decrease in preschool capacity from 60 to 40 due to utilizing a licensed preschool classroom for an infant and toddler program classroom.

Inside and outside approximate measurements were taken during previous inspection on 9/3/21.

Previous inspection informed licensee, Merced County of Education Regional Head Start that the electrical wiring was exposed to children in care. During 9/3/21 inspection, LPAs were informed that work invoices were sent in. As of today, the wiring is still exposed. LPA and LPM observed that the exterior wooded bottom slate is lifting away from building. This in the outside play yard for the two year olds. LPA and LPM observed that the appropriate age sticker was not placed on the climbing structure and the bolts in the preschool play yard are not shaved to recommend size, 3 to 4 threads.

Pending a final file review, a recommendation will be made to license the above facility with a capacity of 40 preschool children.

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 the site supervisor, Misty Mendoza.

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. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISORS NAME: Michael Duarte
LICENSING EVALUATOR NAME: Cynthia Brannon
LICENSING EVALUATOR SIGNATURE: DATE: 04/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/14/2022
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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Document Has Been Signed on 05/06/2022 12:36 PM - It Cannot Be Edited


Created By: Cynthia Brannon On 04/14/2022 at 11:51 AM
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: SAN LUIS HEAD START
FACILITY NUMBER: 243808251

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/14/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/28/2022
Section Cited
CCR
101238(a)

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Buildings and Grounds. The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors. This requirement was not met as evidenced by LPA and LPM's observation of electrical wiring was exposed, exterior wall bottom slate is pulling away from the wall
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Per site supervisor, she will send another work invoice for maintenance to completed. Another inspection will be conducted to ensure corrections took place. Licensee is to contact LPA Brannon no later than 4/28/22.
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in the outside play yard for the two year olds, and that the appropriate age sticker was not placed on the climbing structure. This is a potential personal rights, health and safety to children in care.
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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: 04/14/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/14/2022


LIC809 (FAS) - (06/04)
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