543801735-1-20-2023-57-CC-KPAO-CN9QAT-20230120110029

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 543801735
Report Date: 01/20/2023
Date Signed: 01/20/2023 11:00:34 AM

Document Has Been Signed on 01/20/2023 11:00 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 SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME:	GOLDEN VALLEY PRESCHOOL		FACILITY NUMBER:	543801735
ADMINISTRATOR:	TREVINO, LETICIA		FACILITY TYPE:	850
ADDRESS:	12623 AVENUE 416		TELEPHONE:	(559) 528-6949
CITY:	OROSI	STATE: CA	ZIP CODE:	93647
CAPACITY: 48	TOTAL ENROLLED CHILDREN: 44	CENSUS: 36	DATE:	01/20/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:15 AM
MET WITH:	Vidala Gallegos		TIME COMPLETED:	11:25 AM

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 1/20/23, Licensing Program Analyst (LPA) Kathy Pacheco conducted an unannounced annual inspection at the facility. LPA met with Preschool Facilitator Vidala Gallegos. A tour of the facility was conducted indoors and outdoors. There were no bodies of water, firearms and/or ammunition on the premises. No poisons were observed during the inspection. Furniture and equipment were in good condition, free of sharp, loose or pointed parts. Playground equipment was in safe condition, free of sharp, loose or pointed parts. The surface of the outdoor activity space was maintained in a safe condition and was free of hazards. Areas around high climbing equipment, swings and slides have cushioning material to absorb falls. Children's toilets and hand washing facilities were sanitary and in good operating condition. Floors in the facility were clean and safe. Meals are prepared in the school kitchen and are served in the school cafeteria. Staff escorts children to and from the cafeteria. Solid waste storage containers had tight-fitting covers and were in good repair. Menus are posted at least one week in advance where an authorized representative can view them. Drinking water was available both indoors and outdoors. The facility had one or more functioning carbon monoxide detectors that met statutory requirements. Capacity and limitations as specified on the license are being maintained. The name of the child care center Director or fully-qualified teacher(s) designated to act in the Director's absence has been reported to the Department. The facility maintains a ratio of one teacher supervising no more than 12 children in care. All children are under supervision, including visual supervision, of a teacher at all times. The person who signs the child in/out of the facility shall use their full legal signature and record the time of day. A sample of children's files were reviewed and contained contact information for authorized representative and/or relatives or others who can assume responsibility for the child and medical assessment. Staff files reviewed and documentation observed for health screening, immunization records for pertussis, measles, and influenza and/or declaration declining the flu shot, as well as, current documentation of completed Mandated Reporter Training. At least one person trained in CPR and pediatric First Aid is present when children are at the facility or at off-site activities. (continued on next page)

SUPERVISORS NAME: Luisa Gavoutian
LICENSING EVALUATOR NAME: Kathy Pacheco
LICENSING EVALUATOR SIGNATURE:	DATE: 01/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/20/2023

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

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

FACILITY NAME: GOLDEN VALLEY PRESCHOOL	FACILITY NUMBER: 543801735
	VISIT DATE: 01/20/2023

NARRATIVE

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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 Evaluator Manual - Regulation interpretations and Procedures for Family Child Care Homes Section 102417. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/(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

This facility operates on the traditional school calendar Monday through Friday with one classroom that operates 8:00 AM to 11:00 AM and 12:15 to 3:15. There is a second classroom that operates from 8:00 AM to 2:00 PM.

LPA 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, Lead Poisoning Facts, Forms and Regulations.

Per Title 22, Division 12, Chapter 1 of the California Code of Regulations no deficiencies were observed today.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with Preschool Facilitator Vidala Gallegos .

SUPERVISORS NAME: Luisa Gavoutian
LICENSING EVALUATOR NAME: Kathy Pacheco
LICENSING EVALUATOR SIGNATURE:	DATE: 01/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/20/2023

LIC809 (FAS) - (06/04)

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