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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 100406335
Report Date: 08/21/2024
Date Signed: 08/21/2024 02:37:38 PM

Document Has Been Signed on 08/21/2024 02:37 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, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:FUSD-JEFFERSONFACILITY NUMBER:
100406335
ADMINISTRATOR/
DIRECTOR:		BECKWITH, KIMFACILITY TYPE:
850
ADDRESS:202 N. MARIPOSATELEPHONE:
(559) 457-3690
CITY:FRESNOSTATE: CAZIP CODE:
93701
CAPACITY: 21TOTAL ENROLLED CHILDREN: 21CENSUS: 0DATE:
08/21/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:00 PM
MET WITH:Charlotte MirandaTIME VISIT/
INSPECTION COMPLETED:
03:00 PM
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On 8/21/2024, Licensing Program Analyst (LPA) Priscilla Zamudio conducted an announced case management inspection and met with Charlotte Miranda, Health and Safety Supervisor. LPA explained the reason of the inspection and a tour of the center was conducted both inside and outside. The center is located at 202 N Mariposa Fresno, CA 93701, Jefferson Elementary School.

During today's inspection, LPA verified the following items have been corrected:


Inside Daycare:
. Maintain air conditioner

. Install window screens

Outside Play Area:

· Fence bolts trimmed to 3-4 thread


. Mow lawn
· Repair cracked building trim, gaps and sharp metal near the bottom, front of building
· Install playground structure age requirement stickers

The new classroom #33 is approved for use, however, the following item will need to be completed by 9/6/2024.

· Water lead test for all outlets.

Per Charlotte Miranda, the children will be utilizing an igloo with water cup dispenser with disposable cups until lead water test results are completed. She will notify licensing upon receiving results. LPA observed outlets wrapped in plastic for no use.

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, no deficiencies are cited.


Exit interview conducted and report was reviewed with Charlotte Miranda, Health and Safety Supervisor.

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.
SUPERVISORS NAME: Cynthia Brannon
LICENSING EVALUATOR NAME: Priscilla Zamudio
LICENSING EVALUATOR SIGNATURE: DATE: 08/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/21/2024
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-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: FUSD-JEFFERSON
FACILITY NUMBER: 100406335
VISIT DATE: 08/21/2024
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· Water lead test for all outlets
SUPERVISORS NAME: Cynthia Brannon
LICENSING EVALUATOR NAME: Priscilla Zamudio
LICENSING EVALUATOR SIGNATURE:

DATE: 08/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/21/2024
LIC809 (FAS) - (06/04)
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