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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543810170
Report Date: 08/02/2022
Date Signed: 08/02/2022 11:48:19 AM

Document Has Been Signed on 08/02/2022 11:48 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:SEQUOIA PRESCHOOLFACILITY NUMBER:
543810170
ADMINISTRATOR:AMY SULLIVANFACILITY TYPE:
850
ADDRESS:1040 N WOODLAND STTELEPHONE:
(559) 730-7564
CITY:VISALIASTATE: CAZIP CODE:
93291
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 0DATE:
08/02/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Margaret McLain, AdministratorTIME COMPLETED:
12:00 PM
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On 08/02/2022, Licensing Program Analyst (LPA) Pete Espinoza conducted an announced prelicensing inspection and met with Margaret McLain, Administrator. LPA explained the reason of the inspection and a tour of the center was conducted both inside and outside. The center is located on the campus of Sequoia High School located at 1040 N. Woodland Street in Visalia, 93291. This is a new facility and the applicant is requesting a capacity of 24 preschool children ages 2-6. This is an AM/PM half day program which operates on a traditional school year schedule. Days and hours of operation are Monday through Friday. This program provides two sessions. AM session from 8:00 AM to 11:00 AM. PM session is from 12:00 PM to 3:00 PM.

Director stated that the center will provide breakfast and lunch. Meals are prepared in the school cafeteria. Meals are delivered and children eat in the classroom. All food is protected against contamination and any contaminated food is discarded immediately. Solid waste storage containers have tight-fitting covers and are in good repair. Uncontaminated drinking water is available both indoors and outdoors. Menus are posted at least one week in advance where an authorized representative can view them. Staff will utilize the staff bathroom that's located in 400 wing of campus adjacent to preschool building. Ill children will be isolated in the school nurse's office and utilize the restroom in school nurse's office.

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. There are enough tables, chairs, cots, and plenty of toys for children to play. There is a working carbon monoxide detector inside the kitchen.

LPA reviewed with Margaret McLain, Administrator, that any future changes to the classroom(s) 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.
SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Peter Espinoza
LICENSING EVALUATOR SIGNATURE: DATE: 08/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/02/2022
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: SEQUOIA PRESCHOOL
FACILITY NUMBER: 543810170
VISIT DATE: 08/02/2022
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Room measurements were taken and reviewed with Margaret McLain, Administrator. The total inside preschool area measured to an approximate 1,646 square feet which will accommodate the requested capacity of 24 preschool children at a time. There is adequate storage space available for children's belongings in the classroom. Toys and equipment appear to be age appropriate. There is a total of 2 toilets and 2 sinks/hand washing fixtures which will accommodate the requested capacity of 24 preschool children. Children will use restroom adjacent to classroom that has one toilet and one handwashing sink and second restroom in office that has one toilet and one handwashing sink. Facility will provide bottled water for children to drink both indoors and outdoors. Water will be served in bottles and/or individual cups to be stored in dispenser.

Outdoor measurements were not taken on this date, as the outdoor activity space is adequate enough to accommodate above and beyond the requested capacity of 24 preschool children. The preschool play area is gated all around. LPA observed age appropriate toys, a bike path, slide, and swings. Applicant is using wood chips to cushion fall zones. There is shade available where children can rest and get water. LPA reminded title, name, to provide adequate supervision at all times.

A fire clearance was approved/granted for 24 preschool children by the Visalia City Fire Department on 06/22/2022.

This facility does not plan to provide Incidental Medical Services – IMS. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. A Plan of Operation that includes IMS must be submitted to the Department. 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

Criminal record clearance is completed as condition for employment and maintained by the Visalia Unified School District Administration offices.

This facility does/does not provide care to infants.
SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Peter Espinoza
LICENSING EVALUATOR SIGNATURE:

DATE: 08/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/02/2022
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: SEQUOIA PRESCHOOL
FACILITY NUMBER: 543810170
VISIT DATE: 08/02/2022
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Pending a final file review and completion of above items, a recommendation will be made to license the above facility for the requested capacity of 24 preschool children.

LPA reviewed with Title, name, 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

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 platform.
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.

Exit interview conducted and report was reviewed with Margaret McLain, Administrator.

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: Duane Matsubara
LICENSING EVALUATOR NAME: Peter Espinoza
LICENSING EVALUATOR SIGNATURE:

DATE: 08/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/02/2022
LIC809 (FAS) - (06/04)
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