503601351-9-18-2023-04-CC-PKVE-CVSSS7-20230918140727

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 503601351
Report Date: 09/18/2023
Date Signed: 09/18/2023 02:07:35 PM

Document Has Been Signed on 09/18/2023 02:07 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:	HUGHES HEAD START		FACILITY NUMBER:	503601351
ADMINISTRATOR:	VISCOVICH, ANDREYA		FACILITY TYPE:	850
ADDRESS:	512 NORTH MCCLURE RD		TELEPHONE:	(209) 571-2486
CITY:	MODESTO	STATE: CA	ZIP CODE:	95357
CAPACITY: 23	TOTAL ENROLLED CHILDREN: 15	CENSUS: 11	DATE:	09/18/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Consuelo Centeno		TIME COMPLETED:	02:15 PM

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On 09/18/2023 Licensing Program Analysts (LPAs) Pa Kou Vue and Stephanie Vega-Gonzalez, conducted an unannounced Annual Required Inspection for the preschool license. LPAs met with Staff 1 and Staff 3 and toured the facility indoors and outdoors and a census was taken. Days and hours of operation are August to May, 8:00AM – 2:30PM.

LPA observed no poisons during the inspection. Consuelo Centeno stated there are no poisons on site. Disinfectants, cleaning solutions, medication and other hazardous items are made inaccessible. LPA observed disinfectants and cleaning solutions are stored above the kitchen sink and made inaccessible with the use of a child safety latch.

There is no swimming pool or other bodies of water on the premises. Consuelo Centeno stated there are no firearms or ammunition allowed or stored on the premises.

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. Areas around high climbing equipment, swings and slides have cushioning material to absorb falls. All toilets and handwashing facilities are in safe and sanitary operating condition. Facility has one or more functioning carbon monoxide detectors. Floors in the facility are clean and safe. Solid waste storage containers have tight-fitting covers and are in good repair.

Drinking water is available both indoors and outdoors. Drinking water is provided by drinking fountains and water dispenser and disposable cups. This facility does provide meals to children, snacks are provided. Food is prepared on site. Menus are posted at least one week in advance where an authorized representative can view them. LPA informed Consuelo Centeno, the times for breakfast and lunch must be listed on the menu.

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SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Pa Kou Vue
LICENSING EVALUATOR SIGNATURE:	DATE: 09/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2023

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 09/18/2023 02:07 PM - It Cannot Be Edited

Created By: Pa Kou Vue On 09/18/2023 at 01:15 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: HUGHES HEAD START	FACILITY NUMBER: 503601351
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/18/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101217(a)

Personnel Records

(a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information: This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on staff records review, LPA confirmed staff 3 is missing TB Clearance and LIC503 Health Screening Report, staff 4 is missing LIC503 Health and Screening Report and Conseulo Centeno (Education and Disabilities Coordinator) is missing TB Clearance and LIC503 Health Screening Report. The licensee did not comply with the section cited above in which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 09/29/2023
	Plan of Correction
1 2 3 4	Licensee will submit a copy of the TB Clearances and "original" form for LIC503 Health and Screening Reports to Child Care Licensing Office with POC due date 09/29/2023. Original LIC 503 is to be mailed to office.

Type B

Section Cited

CCR

101220(a)

Child's Medical Assessments

(a) Prior to, or within 30 calendar days following the enrollment of a child, the licensee shall obtain a written medical assessment of the child. This medical assessment enables the licensee to assess whether the center can provide necessary health-related services to the child. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on childrens records review, LPA observed the head start program uses the Stanislaus County Office of Education's Health History form for childrens. The licensee did not comply with the section cited above in which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 09/29/2023
	Plan of Correction
1 2 3 4	Licensee will submit copies of LIC702 Preadmission Health History for all 15 enrolled children via LPA's email. Once submitted to LPA, LPA will verifiy forms. Original LIC702 forms are to be kept in children's files and made readily available to Child Care Licensing upon request.

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:

Juvenal Moctezuma

LICENSING EVALUATOR NAME:

Pa Kou Vue

LICENSING EVALUATOR SIGNATURE:

DATE: 09/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2023

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 RO, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: HUGHES HEAD START	FACILITY NUMBER: 503601351
	VISIT DATE: 09/18/2023

NARRATIVE

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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 childcare center director or fully qualified teacher(s) designated to act in the director’s absence has been reported to the Department. All children are under supervision, including visual supervision, of a teacher at all times. Facility meets teacher-child ratios. 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. Based on childrens records review, LPA observed the head start program uses the Stanislaus County Office of Education's Health History form for childrens.LPA reviewed a sample of staff files and observed files were complete with health screening, immunization records for influenza, pertussis and measles and current documentation of completed mandated reporter training.Based on staff records review, LPA confirmed staff 3 is missing TB Clearance and LIC503 Health Screening Report, staff 4 is missing LIC503 Health and Screening Report and Conseulo Centeno (Education and Disabilities Coordinator) is missing TB Clearance and LIC503 Health Screening Report.

LPA 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.

LPA discussed Reporting Requirements as outlined in the regulations (Section 101212).

Consuelo Centeno 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.

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 Consuelo Centeno the Department website for lead: www.cdss.ca.gov/inforesources/child-care-licensing/water-testing-information.

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SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Pa Kou Vue
LICENSING EVALUATOR SIGNATURE:	DATE: 09/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2023

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 RO, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: HUGHES HEAD START	FACILITY NUMBER: 503601351
	VISIT DATE: 09/18/2023

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LPA discussed safe sleep regulations with Consuelo Centeno and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed Consuelo Centeno of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. 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-carecenters/.

Consuelo Centeno was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to child care 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 Consuelo Centeno. Appeal rights were provided.

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, the following deficiencies are being cited: (see next page).

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: Pa Kou Vue
LICENSING EVALUATOR SIGNATURE:	DATE: 09/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2023

LIC809 (FAS) - (06/04)

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