Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153808853
Report Date: 02/05/2016
Date Signed 02/05/2016 10:10:27 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 E.SHAW AV,STE 300-MS 29-01
FRESNO, CA 93710
FACILITY NAME:BUILDING BLOCKS OF GRACEFACILITY NUMBER:
153808853
ADMINISTRATOR:GAUSE, LEAANNFACILITY TYPE:
850
ADDRESS:2550 JEWETTATELEPHONE:
(661) 589-0424
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93312
CAPACITY:50CENSUS: 6DATE:
02/05/2016
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Lea Ann GauseTIME COMPLETED:
10:30 AM
NARRATIVE
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Licensing Program Analyst (LPA) Brannon met with director, Lea Ann Gause. LPA continued with annual visit on 2/3/16.

Licensee has several rooms licensed in two buildings. At this time, licensee is utilizing the two preschool rooms next to the director's office. The other building that houses the other licensed rooms are not being utilized due to low enrollment. Licensee is aware that when the two licensed rooms in the other building are in use, the toilets are for preschool purposes only.

Type A deficiency was cited. Upon receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months.

Per California Code of Regulations Title 22, Division 12, this deficiency to be cited. Exit interview conducted with director, Lea Ann Gause. The licensee was provided a copy of their appeal rights (LIC 9058 12/15) and their signature on this form acknowledges receipt of these rights. A Notice of Site Visit was posted on parent board.

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
SUPERVISOR'S NAME: Rebecca VarelaTELEPHONE: (559) 243-8106
LICENSING EVALUATOR NAME: Cynthia BrannonTELEPHONE: (559) 341-5155
LICENSING EVALUATOR SIGNATURE:

DATE: 02/05/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/05/2016
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, 770 E.SHAW AV,STE 300-MS 29-01
FRESNO, CA 93710
FACILITY NAME: BUILDING BLOCKS OF GRACE
FACILITY NUMBER: 153808853
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/05/2016
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/12/2016
Section Cited
101238(b)(1)
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Buildings and Grounds. All children shall be protected from hazards within the center through provisions of protective devices including but not limited to nonslip grips on rugs shall be provided. During visit on 2/3/16, LPA observed that the drawers in the classrooms contained sharp scissors, push pins, Sharpies
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Per director, locks will be installed on the drawers and cabinets. During the visit conducted on 2/5/16, LPA observed installed locks in one classroom. In the other classrooms, items were removed from the drawers and placed in cabinets above counter. Per director, locks will be installed on all drawers, and under
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pens, and white out. In the 4 year old classroom, LPA observed the cabinet under the sink contained two cans of Lysol spray. These are health and safety hazards.
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the sink cabinets. Licensee shall send in photographs of drawers and cabinets with installed locks to the Fresno Community Care Licensing office by 2/12/16.
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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: Rebecca VarelaTELEPHONE: (559) 243-8106
LICENSING EVALUATOR NAME: Cynthia BrannonTELEPHONE: (559) 341-5155
LICENSING EVALUATOR SIGNATURE:

DATE: 02/05/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/05/2016
LIC809 (FAS) - (06/04)
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