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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 243808934
Report Date: 03/01/2022
Date Signed: 03/01/2022 02:56:51 PM

Document Has Been Signed on 03/01/2022 02:56 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 PRESCHOOL - MERCEDFACILITY NUMBER:
243808934
ADMINISTRATOR:ROBERTA HEREDIAFACILITY TYPE:
850
ADDRESS:3190 COLLINS DRTELEPHONE:
(209) 626-5741
CITY:MERCEDSTATE: CAZIP CODE:
95348
CAPACITY: 135TOTAL ENROLLED CHILDREN: 135CENSUS: 73DATE:
03/01/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Juan Gama - LicenseeTIME COMPLETED:
03:15 PM
NARRATIVE
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On 3/1/2022 Licensing Program Analysts (LPAs) Joseph Pacheco and Cynthia Brannon, conducted an unannounced Annual Required Inspection for the preschool license. LPA met with Licensee, Juan Gama, and toured the facility indoors and outdoors. Days and hours of operation are Monday – Friday, 6:30am – 6:00pm. Director verified facility phone number is (209) 626-5741.
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. LPAs observed a brown rug near the entrance that was frayed and has a hole forming. All kitchen, food preparation and storage areas are clean, free of litter/rubbish and free of rodents/vermin. All food is protected against contamination and any contaminated food is discarded immediately. Solid waste storage containers have tight-fitting covers and are in good repair. Drinking water is available both indoors and outdoors. The facility is free of flies, insects and rodents. Facility has one or more functioning carbon monoxide detectors that meet statutory requirements.
Licensee 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.
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. The name of the child care center (CCC) director or fully-qualified teacher(s) designated to act in the director’s absence has been
CONTINUED ON 809-C
SUPERVISORS NAME: Diana deLeon
LICENSING EVALUATOR NAME: Joseph Pacheco
LICENSING EVALUATOR SIGNATURE: DATE: 03/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/01/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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Document Has Been Signed on 03/01/2022 02:56 PM - It Cannot Be Edited


Created By: Joseph Pacheco On 03/01/2022 at 12:14 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: BUHACH PRESCHOOL - MERCED
FACILITY NUMBER: 243808934

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/01/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
101229(a)(1)
Responsibility for Providing Care and Supervision
(a) The licensee shall provide care and supervision as necessary to meet the children's needs. (1) No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPAs observation. In Classroom P3 LPAs observed a child using a bathroom stall adjacent to the classroom unattended. LPAs observed one staff sitting at a table working with children and a second staff with her back turned to the bathroom organizing classroom materials. This poses an immediate health, safety or personal rights risk to children in care.
POC Due Date: 03/03/2022
Plan of Correction
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Licensee agreed to watch the video Supervising Children in Child Care Centers on ccld.childcarevideos.org with staff and provide training regarding care and supervision and submit a written plan of who attended the training and how this regulation will be complied with going forward.
Type A
Section Cited
CCR
101216.3(a)
Teacher-Child Ratio
(a) There shall be a ratio of one teacher visually observing and supervising no more than 12 children in attendance, except as specified in (b) and (c) below.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPAs observation. Upon arrival at 8:15am LPAs observed one adult supervising 14 children in the preschool classroom, one adult supervising 18 children in the P3 classroom and one adult supervising 13 children in the P2A Classroom. This poses an immediate health, safety or personal rights risk to children in care.
POC Due Date: 03/03/2022
Plan of Correction
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Licensee stated he will submit a plan of how facility will remain in ratio including a copy of the number of staff members and their schedules.
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: 03/01/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/01/2022


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Document Has Been Signed on 03/01/2022 02:56 PM - It Cannot Be Edited


Created By: Joseph Pacheco On 03/01/2022 at 12:14 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: BUHACH PRESCHOOL - MERCED
FACILITY NUMBER: 243808934

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/01/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101174(d)
Disaster and Mass Casualty Plan
(d) Disaster drills shall be conducted at least every six months.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation of facility fire drill log, LPAs observed that the most recent fire drill was conducted on 8/20/21. This poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/15/2022
Plan of Correction
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Licensee stated he will conduct a fire drill and submit documentation to Community Care Licensing by 3/15/22.
Type B
Section Cited
CCR
101238.3(b)
Indoor Activity Space
(b) The floors of all rooms shall have a surface that is safe and clean.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPAs observation, LPA observed a brown rug near the entrance of the facility that is frayed and has a hole. This poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/15/2022
Plan of Correction
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Licensee has agreed to replace the rug with one that is not damaged and submit documentation to Community Care Licensing by 3/15/22.
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: 03/01/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/01/2022


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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: BUHACH PRESCHOOL - MERCED
FACILITY NUMBER: 243808934
VISIT DATE: 03/01/2022
NARRATIVE
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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. During today’s inspection, LPAs observed a child using the bathroom adjacent to the P3 classroom without visual supervision of staff. Upon arrival at the facility, LPAs observed 14 children being supervised by one adult in the Preschool Classroom, 18 children being supervised by one adult in the P3 classroom and 13 children being supervised by one adult in the Pre2A classroom. 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.
LPA reviewed a sample of staff files and observed one file did not contain a required health screening, four files were missing documentation of either having taken or declined the flu shot. Menus are posted at least one week in advance where an authorized representative can view them. The most recent fire drill was conducted on 8/20/21.

Incidental Medical Services (IMS) are currently being provided. Licensee is aware that an IMS plan is required to be submitted to the licensing office if they provide any of these services. Information regarding Americans with Disability Act (ADA) can be obtained by contacting US Department of Justice toll free ADA Information line at (800) 514-0301(voice), (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm.

LPA and Licensee 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.

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.

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.
CONTINUED ON 809-C
SUPERVISORS NAME: Diana deLeon
LICENSING EVALUATOR NAME: Joseph Pacheco
LICENSING EVALUATOR SIGNATURE:

DATE: 03/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2022
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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: BUHACH PRESCHOOL - MERCED
FACILITY NUMBER: 243808934
VISIT DATE: 03/01/2022
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LPAs Joseph Pacheco and Cynthia Brannon informed Licensee, Juan Gama that this report dated 3/1/2022 documents two Type A citation(s) which shall be posted for 30 consecutive days as there are immediate risks to the health, safety, or personal rights of children in care.
Also, LPAs Joseph Pacheco and Cynthia Brannon informed the licensee to provide a copy of this licensing report dated 3/1/22 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

Exit interview conducted and report was reviewed with the Licensee, Juan Gama.

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: Diana deLeon
LICENSING EVALUATOR NAME: Joseph Pacheco
LICENSING EVALUATOR SIGNATURE:

DATE: 03/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2022
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