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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 243808724
Report Date: 10/18/2021
Date Signed: 10/18/2021 02:34:17 PM

Document Has Been Signed on 10/18/2021 02:34 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:BUHACH PRESCHOOLFACILITY NUMBER:
243808724
ADMINISTRATOR:GAMA, JUANFACILITY TYPE:
850
ADDRESS:2606 N. BUHACH ROADTELEPHONE:
(209) 489-2008
CITY:ATWATERSTATE: CAZIP CODE:
95301
CAPACITY: 89TOTAL ENROLLED CHILDREN: 89CENSUS: 53DATE:
10/18/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Juan Gama - DirectorTIME COMPLETED:
02:45 PM
NARRATIVE
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On 10/18/21, Licensing Program Analyst (LPA) Joseph Pacheco conducted an unannounced case management inspection. LPA met with Licensee to discuss Community Care Licensing (CCL) regulations. LPA discussed the purpose of the inspection with Licensee and obtained a census. During today’s inspection LPA observed a tricycle in the children’s play area that had a broken pedal and food waste in a classroom trash can that did not have a tight fitting cover as required by regulations. LPA also observed mouse glue traps underneath multiple sinks that were not locked and accessible to children in care.

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, the following deficiencies are being cited: (see next page, 809 D). Licensee was provided a copy of their appeal rights.

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: Diana deLeon
LICENSING EVALUATOR NAME: Joseph Pacheco
LICENSING EVALUATOR SIGNATURE: DATE: 10/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/18/2021
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 10/18/2021 02:34 PM - It Cannot Be Edited


Created By: Joseph Pacheco On 10/18/2021 at 11:50 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: BUHACH PRESCHOOL
FACILITY NUMBER: 243808724

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/18/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/01/2021
Section Cited
CCR
101239(f)(1)

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Fixtures, Furniture, Equipment and Supplies. All containers used for storage of solid wastes, including moveable bins, shall have a tightfitting cover that is kept on; shall be in good repair; and shall be leakproof and rodent-proof. This requirement was not met as evidenced by LPA observation.
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Director stated he will purchase a trash can with a tight fitting lid and provide proof of purchase to Community Care Licensing by 11/1/21.
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During inspection LPA observed a banana peel in a trash can that did not have a tightfitting cover. This is a potential risk to the health, safety or personal rights of children in care.
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Type B
10/18/2021
Section Cited
CCR101239(n)

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Fixtures, Furniture, Equipment and Supplies. Furniture and equipment shall be maintained in good condition, free of sharp, loose or pointed parts. This requirement was not met as evidenced by LPA observation. During inspection LPA observed a tricycle in the outdoor play area that was missing a pedal
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Tricycle was removed during the inspection and placed in an area inaccessible to children. Deficiency cleared.
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creating a pointed metal part. This is a potential risk to the health, safety or personal rights of 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:Diana deLeon
LICENSING EVALUATOR NAME:Joseph Pacheco
LICENSING EVALUATOR SIGNATURE:
DATE: 10/18/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/18/2021


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 10/18/2021 02:34 PM - It Cannot Be Edited


Created By: Joseph Pacheco On 10/18/2021 at 11:53 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: BUHACH PRESCHOOL
FACILITY NUMBER: 243808724

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/18/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/01/2021
Section Cited
CCR
101238(g)

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Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children shall be stored where inaccessible to children. This requirement was not met as evidenced by LPA observation. During today’s inspection LPA observed mouse traps underneath sinks in the two year old
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Director stated he will have the broken locks fixed and provide proof to Community Care Licensing by 11/1/21.
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classroom and Pre-K classroom that were not locked due to locks being broken and accessible to children in care. This is a potential risk to the health, safety or personal rights of 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:Diana deLeon
LICENSING EVALUATOR NAME:Joseph Pacheco
LICENSING EVALUATOR SIGNATURE:
DATE: 10/18/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/18/2021


LIC809 (FAS) - (06/04)
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