Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 150405420
Report Date: 02/13/2020
Date Signed: 02/13/2020 12:19:32 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:AGAPELAND CHRISTIAN ACADEMYFACILITY NUMBER:
150405420
ADMINISTRATOR:BANKS, MARISAFACILITY TYPE:
840
ADDRESS:1030 - 4TH STREETTELEPHONE:
(661) 325-4321
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93304
CAPACITY:48CENSUS: 0DATE:
02/13/2020
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Terra Johnson, Assistant DirectorTIME COMPLETED:
12:30 PM
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(3) LPA Pete Espinoza made an unannounced Annual/Random visit. Met with Terra Johnson, Assistant Director. There are no bodies of water. Firearms and other weapons are not allowed or stored on the premises of a child care center. The child care center is clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees, and visitors. In combination programs, outdoor activity space provided for school-age children is physically separate from space provided for child care center children. Disinfectants, cleaning solutions, poisons and other items that are dangerous to children, are inaccessible to children. Storage areas for poisons are locked. All toilets, hand washing, and bathing facilities are in safe and sanitary operating condition. All floors are clean and safe. All kitchen, food preparations and storage areas are kept clean, free of litter, rubbish, and free of rodents and other vermin. Uncontaminated drinking water is readily available both indoors and out. Outdoor activity space surfaces are free of hazards. The areas around or under high climbing equipment, swings, slides and similar equipment are cushioned with material that absorbs a fall. The facility maintains compliance with staff-child ratios. Menus are posted. Facility has one or more functioning carbon monoxide detectors that meet statutory requirements. The licensee shall not exceed the approved capacity of the fire clearance for the facility. No child(ren) shall be left without the supervision, including visual supervision, of a teacher at any time. Prior to working or volunteering in a licensed child care facility, all individuals subject to criminal record review have obtained a clearance or criminal record exemption, or clearance.

Licensee will send to Fresno Regional Office updated Facility Sketch that identifies Room # 21, 22 and modular buildings used for School Age Program.

Operating hours are Mon-Fri 3:00 PM –6:00 PM

Licensee provided proof of required immunization (Pertussis/Measles/Influenza) and written declaration declining flu shot AND Certificate of Completion required Mandated Reporter Training for all staff.
SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Peter EspinozaTELEPHONE: 661-644-8231
LICENSING EVALUATOR SIGNATURE:

DATE: 02/13/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2020
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
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: AGAPELAND CHRISTIAN ACADEMY
FACILITY NUMBER: 150405420
VISIT DATE: 02/13/2020
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Operating hours are Mon-Fri 8:00 AM – 4:00 PM

Incidental Medical Services (IMS) policy was discussed. Incidental Medical Services (IMS) are not currently being provided. Licensee is aware that an IMS plan is required to be submitted to the licensing office if they provide any of these services. When any IMS is provided, an updated 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

NO DEFICIENCIES OBSERVED IN THE AREAS INSPECTED DURING TODAY’S VISIT.
LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS.
SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Peter EspinozaTELEPHONE: 661-644-8231
LICENSING EVALUATOR SIGNATURE:

DATE: 02/13/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2020
LIC809 (FAS) - (06/04)
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