243808137-3-29-2021-04-CC-JMOA-BZKPCV-20210329111231

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 243808137
Report Date: 03/26/2021
Date Signed: 03/29/2021 11:12:37 AM

Document Has Been Signed on 03/29/2021 11:12 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
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME:	DOS PALOS STATE PRESCHOOL		FACILITY NUMBER:	243808137
ADMINISTRATOR:	BIRDSALL, JOANNE		FACILITY TYPE:	850
ADDRESS:	2149 ALMOND STREET		TELEPHONE:	(209) 392-0267
CITY:	DOS PALOS	STATE: CA	ZIP CODE:	93620
CAPACITY: 68	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	03/26/2021
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Virginia Franco		TIME COMPLETED:	12:15 PM

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On 03/26/2021, Licensing Program Analysts (LPAs) Juvenal Moctezuma & Ginny Badhesha conducted an announced Case Management inspection and met with Site Supervisor, Virginia Franco. LPs explained the reason of the inspection and a tour of the center was conducted both inside and outside. The center is located on the premises of Dos Palos Elementary School but has changed its address to 1734 California Ave in Dos Palos, CA. Licensee has added an additional classroom (3) and is wanting to increase their preschool capacity to 78 preschool children ages 3-5 years. This program will operate on a traditional school year schedule and has an AM Session from 8:00 AM to 11:00 AM and PM Session from 12:00 PM to 3:00 PM.

Virginia stated that the district provides children with breakfast and lunch. The food is prepped on site in the school cafeteria. The aides pick up the food in wagons from the school cafeteria and then disburse it to children in each classroom. Staff will utilize the private staff bathroom located in the Teachers lounge and site supervisors office. Ill children will be isolated in the site supervisors office and use the staff bathroom. The classrooms were observed to be clean and free of toxins. The cleaning items/supplies will be stored underneath their classrooms sinks, which will be inaccessible to children. The other cleaning items will be stored in the teachers lounge which children don't have access to. LPAs observed that the furniture and equipment appeared to be safe and in good condition. There are plenty of age appropriate items, tables, chairs, Cots, & cubbies to meet the requested capacity. Since its a half day program, children will not nap.

Room measurements were taken and reviewed with Virginia. The total inside preschool area measured to an approximate 2,350 square feet which will only accommodate 67 preschool children. Virginia amended her application during the inspection. There is adequate storage space available for children's belongings. Toys and equipment appeared to be age appropriate. There is a total of 6 toilets and 6 sinks/hand washing fixtures inside the classrooms. Virginia stated that children get provided with water bottles for both inside and outside.

Report Continued Onto LIC 809-C

SUPERVISORS NAME: Michael Duarte
LICENSING EVALUATOR NAME: Juvenal Moctezuma
LICENSING EVALUATOR SIGNATURE:	DATE: 03/26/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/26/2021

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: DOS PALOS STATE PRESCHOOL	FACILITY NUMBER: 243808137
	VISIT DATE: 03/26/2021

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The playground has a fence that goes all around. There is a shed for storage but is not part of the playground. LPA observed plenty of age appropriate toys, a bike path for children to play, grass, and the shade structure is being installed. The playground has age appropriate stickers on them and licensee is using rubber cushion material to soften the fall zones. The outside play area was measured and reviewed with Virginia and measured to an approximate square footage of 12,948 Square feet which accommodates the preschool capacity of 67 preschool children. LPA reminded licensee to make sure they have visual supervision of children at all times.

A fire clearance for 78 Preschool children was received and granted by the City of Dos Palos Fire Department on 03/02/2021. An amended fire clearance will be sent out to meet its current requested capacity of 67 children.

This facility plans 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

The following items must be completed prior to issuing a license by 04/09/2021.

Classrooms:

Remove brooms and dust pan from children's restroom.
Toilet Cap Missing in bathroom in Classroom #3
Baseboard is missing in classroom #3 bathroom. Please fix the uneven baseboard in the bathroom as well.
First aid kit is missing antiseptic solution and updated First Aid Kit Guide.
Classroom #3 ceiling panels look like water is leaking through, please replace.

Play Area:

Cover Tree Roots in front play area.
Repaint Railings since they're showing rust in classrooms #1 & #2
The wood at the bottom of classroom #1 is loose. Next to children's playground. Needs to be fixed.

Report Continued onto LIC 809-C

SUPERVISORS NAME: Michael Duarte
LICENSING EVALUATOR NAME: Juvenal Moctezuma
LICENSING EVALUATOR SIGNATURE:	DATE: 03/26/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/26/2021

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: DOS PALOS STATE PRESCHOOL	FACILITY NUMBER: 243808137
	VISIT DATE: 03/26/2021

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Piping outside classrooms #1, #2 and teachers lounge needs to be made inaccessible to children by covering the railing.
Fix Rain Gutter next to classroom #1.
Trash bins needs to have lids since food /leftovers is being disposed in them.

Pending a final file review and completion of above items, a recommendation will be made to license the above facility for a capacity of 67 preschool children.

No deficiencies cited during today's visit.
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: Michael Duarte
LICENSING EVALUATOR NAME: Juvenal Moctezuma
LICENSING EVALUATOR SIGNATURE:	DATE: 03/26/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/26/2021

LIC809 (FAS) - (06/04)

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