Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153808357
Report Date: 11/01/2017
Date Signed: 11/01/2017 01:51:39 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:HEIR FORCE ACADEMYFACILITY NUMBER:
153808357
ADMINISTRATOR:RASH, BILLY J.FACILITY TYPE:
850
ADDRESS:4755 GOSFORD ROADTELEPHONE:
(661) 664-1066
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93313
CAPACITY:75CENSUS: 29DATE:
11/01/2017
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Shelby Rash, DirectorTIME COMPLETED:
02:00 PM
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Licensing Program Analyst (LPA) Jessika conducted an unannounced annual/random visit. LPA met with Director Shelby Rash. A tour of the facility, inside and outside, as shown on the facility sketch was made. There are no bodies of water. Firearms and ammunition are not on the premises. Disinfectants, hazardous items and medications are inaccessible to children. Storage area for poisons is locked and inaccessible to children. Furniture, equipment and materials are sufficient, age appropriate, in good repair and toxic free. The playground equipment and outdoor activity space is maintained and in good condition, free of hazards with adequate cushioning material. Children's toilets and hand washing facilities are sanitary and in good operating condition. Rooms and floors are safe and clean. Food preparation area is clean and free of rodent and other vermin. All food and beverages are stored in covered containers at 45 degrees F or less, when applicable. Storage containers for solid waste are in good repair with tight-fitting covers. Sanitary drinking water is available both indoors and outdoors. The licensee is taking measures to keep the facility free of insects, rodents, etc. No excluded adults are present at the facility. Conditions, limitations and capacity specified on license are in compliance. Staff subject to a criminal record clearance or exemption is associated to the facility. First Aid/CPR reviewed and in compliance. Qualified staff designated to act in the Director’s absence has been reported accordingly. Teacher/child ratios are maintained and adequate supervision is provided during visit. Menus are posted. A sample of children's and staff’s records reviewed. Children’s records include required information including; Name, address and telephone number of child’s authorized representative and relatives and/or others who can assume responsibility in the event authorized representative cannot be reached. Staff records contain required documentation of the educational background, training and/or experience.
(Continued on LIC809-C)
SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Jessika ThompsonTELEPHONE: 559-341-4622
LICENSING EVALUATOR SIGNATURE:

DATE: 11/01/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2017
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: HEIR FORCE ACADEMY
FACILITY NUMBER: 153808357
VISIT DATE: 11/01/2017
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Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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

Per California Code of Regulations, Title 22, Division 12, no deficiencies are found on this date.



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: Jessika ThompsonTELEPHONE: 559-341-4622
LICENSING EVALUATOR SIGNATURE:

DATE: 11/01/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2017
LIC809 (FAS) - (06/04)
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