Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153808551
Report Date: 10/27/2016
Date Signed 10/27/2016 12:19:53 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:FALLER STATE PRESCHOOLFACILITY NUMBER:
153808551
ADMINISTRATOR:FRENCH, KRISTINAFACILITY TYPE:
850
ADDRESS:1500 WEST UPJOHNTELEPHONE:
(760) 499-1694
CITY:RIDGECRESTSTATE: CAZIP CODE:
93555
CAPACITY:24CENSUS: 3DATE:
10/27/2016
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Ashley Krantz, Site SupervisorTIME COMPLETED:
12:30 PM
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(3) LPA Pete Espinoza made an unannounced Annual/Random visit. LPA met with Ashley Krantz, Site Supervisor. There are no bodies of water and/or firearms allowed or stored on the premises of a child care center All children are under supervision, including visual supervision, of a teacher at all times. The Department has inspection authority. There is a ratio of one teacher supervising no more than 12 children in attendance. Disinfectants, cleaning solutions, poisons and other dangerous items shall be inaccessible to children. Storage areas for poisons are locked. All materials and surfaces accessible to children are toxic free. All toilets, hand washing, and bathing facilities are in safe and sanitary operating conditions. All floors are clean and safe. Furniture and equipment are in good condition, free of sharp, loose, or pointed parts. All kitchen, food prep, and storage areas are clean, free of litter, rubbish, and rodents/vermin. All food is protected from contamination, and contaminated food is discarded immediately. Solid waste storage vessels, including moveable bins, have tight-fitting covers on, are in good repair. Uncontaminated drinking water is available both indoors and outdoors. All foods/beverages capable of rapid spoiling are stored in covered containers at 45 (F) or less. Menus are posted at least one week in advance, where an authorized representative can view them, are dated and kept on file for 30 days, and are available on request. Facility has one or more functioning carbon monoxide detectors that meet statutory requirements. Playground equipment is in good condition, free of sharp, loose, or pointed parts. Outdoor activity space surface is maintained in a safe condition and is free of hazards. Areas around high climbing equipment, swings, and slides have cushioning material to absorb falls. Before working or volunteering in a licensed child care facility, all individuals subject to a criminal record review have a clearance or exemption and have been associated to the facility.
SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Peter EspinozaTELEPHONE: 661-644-8231
LICENSING EVALUATOR SIGNATURE:

DATE: 10/27/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2016
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 2


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: FALLER STATE PRESCHOOL
FACILITY NUMBER: 153808551
VISIT DATE: 10/27/2016
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Staff records contain appropriate, documentation of education credits. At least one person trained in CPR and Pediatric first-aid is present when children are at the facility or at off-site activities. The person, who signs the child in/out, is responsible for the child, uses their full legal signature and records the time of day. Child's admission agreement is available for review.

Facility operates AM/PM sessions; Mon-Fri 8:00 AM – 11:30 AM & 12:30 PM – 4:00 PM

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

NO DEFICIENCIES OBSERVED IN THE AREAS INSPECTED DURING TODAY’S VISIT.



A COPY OF THIS REPORT MUST REMAIN IN THE FACILITY FOR PUBLIC REVIEW

To order forms, etc. visit our website at www.ccld.ca.gov.
SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Peter EspinozaTELEPHONE: 661-644-8231
LICENSING EVALUATOR SIGNATURE:

DATE: 10/27/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2016
LIC809 (FAS) - (06/04)
Page: 2 of 2