503600402-9-21-2023-04-CC-MHEA-CVW9Q9-20230921233359

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 503600402
Report Date: 09/21/2023
Date Signed: 09/21/2023 11:34:29 PM

Document Has Been Signed on 09/21/2023 11:34 PM - 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:	ST. STANISLAUS PRESCHOOL		FACILITY NUMBER:	503600402
ADMINISTRATOR:	LOPEZ, BIANCA		FACILITY TYPE:	850
ADDRESS:	1416 MAZE BLVD		TELEPHONE:	(209) 524-9036
CITY:	MODESTO	STATE: CA	ZIP CODE:	95351
CAPACITY:	51	CENSUS: 6	DATE:	09/21/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Director Sulu Martinez		TIME COMPLETED:	05:30 PM

NARRATIVE

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On September 21, 2023, Licensing Program Analyst (LPA) Miguel Herrera, conducted an unannounced annual inspection. LPA met with Preschool Director Sulu Nunez. Preschool has two sessions partial day and full day with 22 children enrolled. LPA conducted a census during the inspection and only 6 children were present. LPA toured the facility, both indoors and outdoors to inspect areas accessible to children in care. This year the school year started 08/10/2023 and ends on 05/25/2024 and operates Monday through Friday from 7:30 AM to 5:45 PM. LPA confirmed the facility has a working telephone service at (209)-524-3428.

LPA toured the facility indoors and outdoors, and a census was taken and there are 6 children in the full day classroom with two qualified teachers. LPA Herrera observed all required licensing forms to be posted in a visible location for authorized representatives to view them. All children are under supervision, including visual supervision, of a teacher at all times. There is a ratio of one teacher supervising no more than twelve children in attendance. Capacity and limitations as specified on the license are being maintained.

LPA Herrera observed a sign in/out sheet for the usage of parents and/or authorized representatives in the full day classroom. The sign in/out sheets documented a full legal signature and a record of the time of day.

There is no swimming pool or other bodies of water on the premises. There are no firearms or ammunition allowed or stored on the premises. The LPA did not observe disinfectants, cleaning solutions and other dangerous items to be accessible to children. There were no poisons observed on the premises accessible to children. Licensee is aware that poisons are required to be locked and inaccessible to children.

To be continued on 809-C.

SUPERVISOR'S NAME: Juvenal Moctezuma	TELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Miguel Herrera	TELEPHONE: (559) 341-0721
LICENSING EVALUATOR SIGNATURE:	DATE: 09/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2023

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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Document Has Been Signed on 09/21/2023 11:34 PM - It Cannot Be Edited

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: ST. STANISLAUS PRESCHOOL	FACILITY NUMBER: 503600402
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/21/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.7995(a)(1)

General Provisions and Definitions

(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above, as all three staff files were missing immunization records (influenza, pertussis, and measles) which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 10/05/2023
	Plan of Correction
1 2 3 4

Type B

Section Cited

CCR

101215.1(f)

Child Care Center Director Qualifications and Duties

(f) When the child care center director is absent from the center, arrangements shall be made for a fully qualified teacher as specified in Section 101216.1(c) to act as substitute. This substitute child care center director shall be aware of center operations, including total enrollment; shall be trained in program operation; and shall be designated as an authorized person to correct operational deficiencies that constitute immediate threats to children's health and safety. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above, as the department was not notified about a director change. Upon record review, LPA Herrera observed an incomplete director’s packet for the new Director. LPA Herrera and Director Nunez reviewed the file together and compiled a list of required documents that must be submitted to Fresno RO by 10/05/2023.
	POC Due Date: 10/05/2023
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Juvenal Moctezuma	TELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Miguel Herrera	TELEPHONE: (559) 341-0721
LICENSING EVALUATOR SIGNATURE:	DATE: 09/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 09/21/2023 11:34 PM - It Cannot Be Edited

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: ST. STANISLAUS PRESCHOOL	FACILITY NUMBER: 503600402
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/21/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101216(g)(1)

Personnel Requirements

(1) Except as specified in (3) below, good physical health shall be verified by a health screening, including a test for tuberculosis, performed by or under the supervision of a physician not more than one year prior to or seven days after employment or licensure. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, Staff #1 and #3 did not have proof of the health screening, including a test for tuberculosis, performed by or under the supervision of a physician that he or she is in good physical health. Facility representative agrees that she/he will ensure that Staff #1 and #3 obtain the proof of the health screening by his/her physician.
	POC Due Date: 10/05/2023
	Plan of Correction
1 2 3 4

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Juvenal Moctezuma	TELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Miguel Herrera	TELEPHONE: (559) 341-0721
LICENSING EVALUATOR SIGNATURE:	DATE: 09/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2023

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: ST. STANISLAUS PRESCHOOL	FACILITY NUMBER: 503600402
	VISIT DATE: 09/21/2023

NARRATIVE

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During the inspection, LPA observed furniture and equipment are in good condition, free of sharp, loose, or pointed parts. The facility has sufficient age-appropriate furniture, and equipment. Playground equipment is in safe condition, free of sharp, loose or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. LPA observed adequate cushioning in the form of rubber wood chips underneath the play structure and landing of the slides to absorb falls. LPA advised for Director to have the staff conduct frequent safety inspections of the outdoor play structure and to check for any loose parts, cracks, and hazards. The Director is aware of child safety around the play structure and assumes all responsibility. The Director understands that children must be always supervised while using the play structure.

The facility has a complete first aid kit, including bandages, scissor, thermometer, gloves and a first aid manual. Drinking water is available both indoors and outdoors by means of drinking fountains with spouts for children. These outlets were inspected and have water on and in working condition. Morning snack, afternoon snack, and lunch is prepared in the cafeteria. Lunch and snacks are served in the classroom for the preschool children. 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. Menus are posted at least one week in advance where an authorized representative can view them.
The facility is free of flies, insects, and rodents. Facility has one or more functioning carbon monoxide detectors that meet the statutory requirements. There is a working fire extinguisher and adequate heating and ventilation for safety and comfort. Fire drills are conducted and documented with the date, time and how many children present, every six months.

As a condition of employment, all staff are to have a fingerprint clearance prior to working or volunteering in a licensed child care facility, all individuals subject to a criminal record review have received a criminal record clearance or exemption. Upon notification from the Department, the licensee will comply and act immediately to terminate the employment of, remove from the facility or bar from entering the facility for any person it is deemed necessary while the Department considers granting or denying an exemption.

To be continued on 809-C.

SUPERVISOR'S NAME: Juvenal Moctezuma	TELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Miguel Herrera	TELEPHONE: (559) 341-0721
LICENSING EVALUATOR SIGNATURE:	DATE: 09/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2023

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: ST. STANISLAUS PRESCHOOL	FACILITY NUMBER: 503600402
	VISIT DATE: 09/21/2023

NARRATIVE

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At least one person trained in CPR and Pediatric First Aid is present when children are at the facility or at offsite activities. The name of the childcare center director or fully-qualified teacher designated to act in the director’s absence had not been reported to the Department. LPA Herrera reviewed an incomplete director’s packet for the center’s new director (Citation Type B on 809-D). LPA reviewed a sample of children’s files and observed files were complete with contact information for authorized representative and or relatives or others who can assume responsibility for the child and medical assessments. LPA reviewed a sample of staff files and observed files were incomplete for all staff. Citation (Type B) was issued to provide evidence to the department for immunization records for pertussis and measles and documentation for tuberculosis screening for staff (See 809D).

LPA discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to resources such as forms, regulations Provider Information Notices (PINs), and Quarterly Updates.

LPA discussed Reporting Requirements as outlined in the regulations (Section 101212).

The Director was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For childcare center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1- CCP). LPA verified that the lead testing was completed in accordance with the Written Directives outlined in PIN 21-21.1-CCP. LPA referred the Director to the Department website for lead: www.cdss.ca.gov/inforesources/child-care-licensing/water-testing-information.

To be continued on 809-C.

SUPERVISOR'S NAME: Juvenal Moctezuma	TELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Miguel Herrera	TELEPHONE: (559) 341-0721
LICENSING EVALUATOR SIGNATURE:	DATE: 09/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2023

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: ST. STANISLAUS PRESCHOOL	FACILITY NUMBER: 503600402
	VISIT DATE: 09/21/2023

NARRATIVE

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LPA discussed safe sleep regulations with the Director and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed the Director of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. 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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

The Director was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Exit interview conducted and report was reviewed with Sulu Nunez. Appeal rights were provided.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following deficiencies are being cited: (see 809-D).

This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.

SUPERVISOR'S NAME: Juvenal Moctezuma	TELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Miguel Herrera	TELEPHONE: (559) 341-0721
LICENSING EVALUATOR SIGNATURE:	DATE: 09/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2023

LIC809 (FAS) - (06/04)

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