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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 503810266
Report Date: 05/24/2024
Date Signed: 05/24/2024 12:53:53 PM

Document Has Been Signed on 05/24/2024 12:53 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:HAZEL'S CHRISTIAN PS & CHILDCARE CENTER 24 HOURSFACILITY NUMBER:
503810266
ADMINISTRATOR/
DIRECTOR:		JESSICA MOUAFACILITY TYPE:
860
ADDRESS:133 E ROSEBURG AVETELEPHONE:
(209) 735-9359
CITY:MODESTOSTATE: CAZIP CODE:
95350
CAPACITY: 104TOTAL ENROLLED CHILDREN: 104CENSUS: 0DATE:
05/24/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Hazel Domson - ApplicantTIME VISIT/
INSPECTION COMPLETED:
01:00 PM
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On 5/24/24 at 9:30 am, Licensing Program Analyst (LPA), Joseph Pacheco and conducted an announced Pre-Licensing inspection for a new license. Upon arrival, LPA and met with Applicant, Hazel Domson. Applicant is requesting to be licensed for 80 preschoolers ages 2-6 in classrooms 2-5; and 24 infant children ages 0-2 in classroom 1. Hours of operation will be Monday – Friday, 6:00 am – 7:00 pm. This facility will operate year-round.
All indoor and outdoor activity spaces utilized for the children was inspected today. LPA informed Applicant that staff are required to always maintain direct visual supervision of the children during indoor and outdoor activities. When medications are on site, Applicant stated that they will be stored in the Director’s office. A fully equipped first aid kit is was not observed. Applicant stated that when the first aid kits are obtained, they will be stored in each classroom. There are operational carbon monoxide detector(s) on site located in each classroom. Required documents were not posted but Applicant states they will be posted in the lobby. Children will be signed in and out at the front desk.
LPA continued to tour the facility and measured all indoor and outdoor activity spaces. Total indoor activity space for the preschool classrooms measured to an approximate 3,446 square feet which will accommodate 80 preschool children. Total indoor activity space for the infant classroom measured to an approximate 555 square feet which will only accommodate 15 infant children. LPA observed all indoor activity space to be complete with safe, age-appropriate furniture and equipment, including tables, chairs, cubbies, napping cots, cribs, bookshelves, and other activity supplies for the children. Infant toys are safe with no sharp edges, splinters, or points, nor made of small parts that can present a choking hazard. Facility will utilize an outside water delivery service to provide drinking water. Facility utilizes water pitchers in each classroom to make water readily available for children. Children bring their own water bottles from home, but the facility keeps cups on hand in the event a child does not have a water bottle. LPA observed all hazardous items to be inaccessible to children. There are no bodies of water or weapons on the property. Fire clearance for 80 preschool children and 24 infant children was granted by the City of Modesto Fire Department on 5/15/24.
In the infant room high chairs and feeding tables have broad-based legs, plastic seats are in good repair and
CONTINUED ON LIC809-C
SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Joseph Pacheco
LICENSING EVALUATOR SIGNATURE: DATE: 05/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/24/2024
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 5
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: HAZEL'S CHRISTIAN PS & CHILDCARE CENTER 24 HOURS
FACILITY NUMBER: 503810266
VISIT DATE: 05/24/2024
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trays lock onto chairs. High chairs are made of washable, moisture-resistant material. Changing tables did not have at least 1” padding covered with moisture-resistant, washable material. Sides of the changing table are at least 3” high and the changing table is within arm’s reach of a sink. Diapering sink is not used for meal preparation or dishwashing. Cribs meet regulatory requirements. Crib area was not separated from the rest of the infant classroom. Sleep logs and Infant Needs and Services Plans and Sleep Plans are kept in a binder in the infant’s classroom.
LPA observed a total of 14 sinks and 10 toilets available for preschool children’s use. LPA observed a total of one sink in the infant classroom. Facility will not be providing potty training services at this time. These are sufficient to accommodate the revised overall capacity of 95 children. There is a separate staff restroom equipped with a toilet and a sink. The isolation area for children who are ill will be in the Director’s office and ill children will utilize the staff bathroom located across from the Director’s office.
Facility will provide an AM and PM snack. Parents provide food for lunches. Facility has food available in the event a parent forgets to provide their child with food. The kitchen area currently includes a refrigerator and freezer. The kitchen area and food storage areas were observed to be free of rodents and/or vermin. Food was observed to be properly stored separate from cleaning materials. Hazardous items in kitchen are inaccessible to children via being located separately from the classrooms.
The facility currently has a fully fenced separate playground area for the infant component. Applicant has two separate fully fenced playground areas for the preschool component. The wooden fencing along the perimeter is at least four feet high. There is chain link fencing that separates the two preschool outdoor activity areas. The wooden fence separating the infant outdoor area from the large preschool outdoor area was not four feet high. The total square footage for the outdoor activity space for the preschool is 17,868 square feet which is sufficient to accommodate up to 80 children. The total square footage for the outdoor activity space for the infants is 2,068 square feet which is sufficient to accommodate 15 infant children. There was no shade structure observed in the infant outdoor activity area. Shade is provided in the preschool outdoor activity spaces with mature trees. There are sufficient outdoor age-appropriate toys and play equipment available on the playgrounds. There is no climbing structure in the infant playground. LPA observed two high climbing play structures in the big preschool playground area and one high climbing play structure in the small preschool playground area. The play structures were properly anchored but LPA was not able to verify if the high climbing equipment was age appropriate for ages 2-6. There is wood chip cushioning in in the high climbing equipment areas. Staff bring the water pitchers outside during outdoor activities. Children will bring their water bottles outside. LPA observed all hazardous items on the playground(s) to be inaccessible to children.
CONTINUED ON LIC809-C
SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Joseph Pacheco
LICENSING EVALUATOR SIGNATURE:

DATE: 05/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2024
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: HAZEL'S CHRISTIAN PS & CHILDCARE CENTER 24 HOURS
FACILITY NUMBER: 503810266
VISIT DATE: 05/24/2024
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Applicant was reminded that any changes to the facility must be reported to and approved by Community Care Licensing.

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).

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.

This facility plans to provide Incidental Medical Services – IMS. For IMS information, see PIN 22-02-CCP. Applicant has an IMS plan on file with 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.

LPA reviewed with applicant the LIC 311A, Records to Be Maintained at The Facility, for child’s records, personnel records, administrative records, and documents to be posted.

LPA discussed the safe sleep regulations with applicant and discussed the Child Care Licensing Safe Sleep webpage at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep, as an additional resource. LPA also informed applicant 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.
CONTINUED ON LIC809-C
SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Joseph Pacheco
LICENSING EVALUATOR SIGNATURE:

DATE: 05/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2024
LIC809 (FAS) - (06/04)
Page: 3 of 5
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: HAZEL'S CHRISTIAN PS & CHILDCARE CENTER 24 HOURS
FACILITY NUMBER: 503810266
VISIT DATE: 05/24/2024
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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 https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.
The following corrections are needed prior to the issuance of the license:

Inside Activity Area
1) Install a partition that is at least 48 inches high to separate the crib space in the infant room from the rest of the classroom.
2) Wipe down all counter tops and clean out all drawers in each classroom or install child safety locks to make inaccessible to children in care.
3) Obtain padding for changing tables that meet Title 22 regulations.
4) Obtain a first aid kit that includes a current edition of a first aid manual, adhesive tape, scissors, tweezers, thermometer and antiseptic solution per Title 22 regulations.

Outside Activity Area:
1) Add wood chip cushioning to play structure in northeast corner of the large preschool outdoor activity area.
2) Remove cobwebs and tree debris from outdoor play equipment from the large and small preschool outdoor activity areas.
3) Remove wood plank from small preschool outdoor play area.
4) Install alarms on exit doors that lead from the small preschool play area and infant play area to the outside of the premises.
5) Pad or remove the two metal poles in the large preschool outdoor activity area.
6) Install shade structure in infant outdoor play area.
7) Fix broken window screen in infant outdoor play area.
CONTINUED ON LIC809-C
SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Joseph Pacheco
LICENSING EVALUATOR SIGNATURE:

DATE: 05/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2024
LIC809 (FAS) - (06/04)
Page: 4 of 5
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: HAZEL'S CHRISTIAN PS & CHILDCARE CENTER 24 HOURS
FACILITY NUMBER: 503810266
VISIT DATE: 05/24/2024
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8) Make the fence separating the infant outdoor activity space and the large preschool activity space at least 4 feet high.
9) Obtain manufacturers specification information to verify the high climbing play equipment in both preschool outdoor activity areas is age appropriate for children ages 2-6.
10) Repair or remove play train in the big preschool outdoor activity area.

Applicant understands that all proof of corrections must be provided to the Department within 30 days, or the application may be denied. Pending a final file review and completion of the above items, a recommendation will be made to license the facility for 15 infants and 80 preschool children.

Exit interview conducted and report was reviewed with Applicant, Hazel Domson.
SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Joseph Pacheco
LICENSING EVALUATOR SIGNATURE:

DATE: 05/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2024
LIC809 (FAS) - (06/04)
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