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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 243810158
Report Date: 07/30/2021
Date Signed: 07/30/2021 04:41:24 PM

Document Has Been Signed on 07/30/2021 04:41 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
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:MERCEY SPRINGS PRESCHOOLFACILITY NUMBER:
243810158
ADMINISTRATOR:ROCHA, JENNIFERFACILITY TYPE:
850
ADDRESS:1900 S MERCEY SPRINGS RDTELEPHONE:
(209) 826-2241
CITY:LOS BANOSSTATE: CAZIP CODE:
93635
CAPACITY: 24TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
07/30/2021
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Jennifer RochaTIME COMPLETED:
05:00 PM
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 A pre-licensing inspection visit was conducted on this date by Licensing Program Analyst (LPA) Brannon, who met with Program Director, Jennifer Rocha. The center is located at Mercey Springs Elementary school. The licensee is requesting a preschool capacity of 24. This program will operate traditional school-year, Monday through Friday; AM session from 8:30 to 11:30 AM and PM session from 12:30 PM to 3:30 PM. Breakfast and lunch will be provided and prepared at Mercey Springs Elementary cafeteria. There is not a sink with hot water inside kitchen area. The kitchen area receives meals from the cafeteria and is the area where the food will be prepared to be served to the children. Ill children and staff will utilize the bathroom located in the office next door. Ill children will be isolated in the office next door or in the school nurse's office, depending upon the situation. Room measurements taken and reviewed with Jennifer Rocha. There is one classroom that will be used by preschool children. The total preschool square footage is 1158 which will accommodate the requested capacity of 24 preschool children. The total preschool square footage for the outside play area is 16836, which will accommodate the requested capacity of 24 preschool children. The outside drinking fountain will not be utilized at this time due to the COVID pandemic.
There are 2 toilets and 2 sinks/hand washing fixtures in the children's bathrooms which will accommodate the requested capacity of 24 preschool children. LPA is recommending that licensee installs a sink in the classroom. This can help prevent the spread of E. coli There is not a drinking water fountain in the classroom. An Igloo will be utilized for indoor drinking water. Licensee is providing water bottles for the children. The water bottles will be labeled with the children's names. Licensee is using wood chips as cushioning. The fire clearance has been received and approved for the requested capacity of 24 preschool children.
Incidental Medical Services (IMS) policy was discussed. 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 CONTINUED ON THE FOLLOWING PAGE
SUPERVISORS NAME: Michael Duarte
LICENSING EVALUATOR NAME: Cynthia Brannon
LICENSING EVALUATOR SIGNATURE: DATE: 07/30/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/30/2021
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: MERCEY SPRINGS PRESCHOOL
FACILITY NUMBER: 243810158
VISIT DATE: 07/30/2021
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Per Jennifer Rocha, there will be five staff providing care to 24 preschool children in the preschool classroom. There is no storage in the classroom for teachers.
The following items must be completed prior to issuing a license by :
1. There are two holes at the ramp entrance.
2. There are gaps in the side of the ramp that needs to be corrected.
3. There is rust on the exterior wall and one vertical wood panel may have wood rot.
4. Temporary fencing on the south side of the building.
5. There are fencing screws with screws sticking up from the cement with more than 3 exposed threads.
6. There are spider webs on the east exterior ceiling.
7. There is a loose exterior plank on the west side.
8. The shelving units and book shelving are to be anchored to prevent tipping over onto a child.
9. White boards prevent visual supervision are to be placed elsewhere or removed.
10. The play closet in the dramatic play area can tip over and needs to be anchored.
11. The four children's chairs are to be repainted and sanded as needed.
12. There is not permanent shade structure as required in the outside play area. The building next to the outside play area has an over hang. LPA appraised LPM Duarte. For now, an anchored shade structure will be acceptable. Work on the permanent structure shall begin within three months. A work invoice with estimated completion date shall be included.
13. Rake chips into the fall zones.
Pending a final file review and completion of above items, a recommendation will be made to license the above facility for a capacity of 24 preschool children.
Please update LIC 500, LIC 610, LIC 308, Facility Sketch upon licensure.
The following documents should be posted at the facility:
* PUB 269- Child passenger restraint systems poster 101225(f) Transportation
* Pub 393- Notification of Parents Rights 101218.1(c) Admission Procedures
* License 101160(a) License
* Menus 101227(a)(6) Food Services
* LIC 613A- Personal Rights form 101223(b)(2) Personal Rights
* LIC 610- Disaster Plan 101174(a)
* LIC 9148- Earthquake Preparedness Checklist 101174(b)
* Lead Poisoning brochure
*COVID posters
To order forms, etc. visit our website at www.ccld.ca.gov.
SUPERVISORS NAME: Michael Duarte
LICENSING EVALUATOR NAME: Cynthia Brannon
LICENSING EVALUATOR SIGNATURE:

DATE: 07/30/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2021
LIC809 (FAS) - (06/04)
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