243810252-10-16-2023-04-CC-JPAO-CWNRTH-20231016131821

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 243810252
Report Date: 10/16/2023
Date Signed: 10/16/2023 01:18:35 PM

Document Has Been Signed on 10/16/2023 01:18 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 RO, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME:	PLAY ADVENTURES INC		FACILITY NUMBER:	243810252
ADMINISTRATOR:	NAOMI SUKENIK		FACILITY TYPE:	850
ADDRESS:	655 G ST		TELEPHONE:	(209) 600-3372
CITY:	MERCED	STATE: CA	ZIP CODE:	95341
CAPACITY: 25	TOTAL ENROLLED CHILDREN: 25	CENSUS: 0	DATE:	10/16/2023
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Naomi Sukenik		TIME COMPLETED:	01:30 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 10/16/23, Licensing Program Analyst (LPA) Joseph Pacheco conducted an announced pre-licensing inspection and met with Applicant, Naomi Sukenik. LPA reviewed the reason of the inspection, and a tour of the center was conducted both inside and outside. The center is located at address 655 G Street, Merced, CA 95341. This is a new facility, and the applicant is requesting a license for 22 preschool children ages 2-5. This program will operate year round with full day and half day options from 7:30 AM to 5:30 PM Monday through Friday. This program will operate in Classroom 9. Applicant is aware to contact Fresno Community Care Licensing for a change in classrooms and/or change in capacity. Parents will take their children to the front gate and staff will conduct the daily health check and escort them to their classroom. Parents may also escort their children to the classroom. Applicant stated that the facility does not provide food or snacks. Children’s authorized representatives provide food and snacks. Facility does have a supply of food on site in case parent forgets to send their child with food. Staff will utilize the bathroom located in the staff office (Classroom 12). Ill children will be isolated in the Center Director’s office and utilize the staff bathroom. The classroom was observed to be clean and free of toxins. LPA observed that the furniture and equipment appeared to be safe and in good condition. The cubbies and tall indoor play equipment are anchored to prevent tipping onto children in care. There are enough tables, cubbies, sleeping cots/mats and plenty of toys for children to play. LPA also reminded Applicant to not store anything on top of high shelves that could potentially fall on children. There are working smoke detectors that are wired throughout the building and carbon monoxide detectors in in the classroom. LPA reviewed with Applicant, that any future changes to the classrooms 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. Room measurements were taken and reviewed with Applicant. The total inside preschool area measured to an approximate 813 square feet which will accommodate the requested capacity of 22 preschool children. CONTINUED ON LIC809-C

SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Joseph Pacheco
LICENSING EVALUATOR SIGNATURE:	DATE: 10/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2023

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 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: PLAY ADVENTURES INC	FACILITY NUMBER: 243810252
	VISIT DATE: 10/16/2023

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
26
27
28
29
30
31
32

Applicant understands that children's equipment needs to match the capacity she is licensed for. Toys and equipment appear to be age appropriate. There are a total of 2 toilets and 2 sink/hand washing fixtures, located inside the classroom, which will accommodate the requested capacity of 22 preschool children. There is also a sink located outside at the gated entrance for children to wash their hands upon arrival. Facility will be providing diapers and wipes for those children who are not potty trained. Facility will have staff obtain drinking water by filling up five gallon water jugs from a nearby water vendor machine. This water will be used to fill pitchers in the classroom. Children will bring water bottles from home to use throughout the day. The water pitchers will be taken outside and utilized to provide water during outdoor activities. For child care 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).
The outside square footage is approximately 3,849 square feet which will accommodate 22 preschool children. LPA observed age appropriate toys and play equipment. Rubber cushioning is used under high climbing play equipment. There is a shade structure over the high climbing play equipment. LPA reminded Applicant that visual supervision is to be provided to children in care at all times.
Applicant 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, 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.

A fire clearance for a capacity of 22 preschool children was approved and granted by the State of California, Office of State Fire Marshall on 10/12/23.

The following items must be completed prior to issuing a license:

Inside Daycare:
1) Obtain a thermometer for the first aid kit.
2) Obtain five additional chairs to meet the requested capacity of 22 preschool children.

Outside Daycare:
1) Make the fence separating the preschool and school age outdoor play area, four feet high to meet required regulations.
CONTINUED ON LIC809-C

SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Joseph Pacheco
LICENSING EVALUATOR SIGNATURE:	DATE: 10/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2023

LIC809 (FAS) - (06/04)

Page: 2 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: PLAY ADVENTURES INC	FACILITY NUMBER: 243810252
	VISIT DATE: 10/16/2023

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
26
27
28
29
30
31
32

This facility plans to provide Incidental Medical Services – IMS. For IMS information, see PIN 22-02-CCP. Applicant has submitted an IMS plan to the Fresno Regional Office. 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, available at: http://www.ada.gov/childqanda.htm.

Pending a final file review and completion of the above items, a recommendation will be made to license the above facility for the requested capacity of 22 preschool children.

LPA reviewed with facility representative 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

Applicant was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

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 platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at
CONTINUED ON LIC809-C

SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Joseph Pacheco
LICENSING EVALUATOR SIGNATURE:	DATE: 10/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2023

LIC809 (FAS) - (06/04)

Page: 3 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: PLAY ADVENTURES INC	FACILITY NUMBER: 243810252
	VISIT DATE: 10/16/2023

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
26
27
28
29
30
31
32

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 Applicant, Naomi Sukenik.

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: Deborah Lowe
LICENSING EVALUATOR NAME: Joseph Pacheco
LICENSING EVALUATOR SIGNATURE:	DATE: 10/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2023

LIC809 (FAS) - (06/04)

Page: 4 of 4