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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 503810266
Report Date: 05/31/2024
Date Signed: 05/31/2024 10:50:01 AM

Document Has Been Signed on 05/31/2024 10:50 AM - 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:
05/31/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Hazel Domson - ApplicantTIME VISIT/
INSPECTION COMPLETED:
11:00 AM
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On 5/31/24, Licensing Program Analyst (LPA) Joseph Pacheco conducted an announced pre-licensing inspection and met with Applicant, Hazel Domson. LPA reviewed the reason of the inspection, and a tour of the center was conducted both inside and outside.

During today's inspection, LPA verified the following items have been corrected:

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) Removed 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: 05/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/31/2024
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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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: 05/31/2024
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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) Removed play train in the big preschool outdoor activity area.

Applicant stated that the play structure located on the east side of the building in the small preschool outdoor activity area is for ages 5-12. The play structure in the northeast section of the large outdoor preschool activity area is for ages 2-12 and the high climbing structure in the northwest corner of the large outdoor preschool activity area is for ages 3-6. Applicant stated that day care staff will use visual supervision to ensure that manufacturer guidelines are followed in the use of all high climbing play equipment and that preschool children do not use any high climbing play equipment that is not appropriate for their age.

Applicant stated she will email LPA manufacturers information regarding the high climbing play equipment.

Pending a final file review, a recommendation will be made to license the above facility for the requested capacity of 80 preschool children and 15 infant children.

Exit interview conducted and report was reviewed with Applicant, Hazel Domson. 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: 05/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2024
LIC809 (FAS) - (06/04)
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