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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 100403323
Report Date: 01/19/2023
Date Signed: 01/19/2023 11:22:19 AM

Document Has Been Signed on 01/19/2023 11:22 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
FRESNO SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:FRESNO EOC WILSON HEAD STARTFACILITY NUMBER:
100403323
ADMINISTRATOR:RODRIGUEZ, ANGELITAFACILITY TYPE:
850
ADDRESS:1325 STILLMANTELEPHONE:
(559) 263-1205
CITY:SELMASTATE: CAZIP CODE:
93662
CAPACITY: 28TOTAL ENROLLED CHILDREN: 28CENSUS: 13DATE:
01/19/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Florence Paredes TIME COMPLETED:
11:30 AM
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On 1/19/2023, Licensing Program Analysts (LPAs) Ruby Ocegueda and Denisia Jimenez conducted an unannounced case management – unusual incident inspection. LPA’s met with Teacher Assistant Florence Paredes. LPA’s toured the facility and took a census. The purpose of today's inspection was to follow-up on an unusual incident that was reported to Community Care Licensing (CCL) on 12/15/2022. The Incident reported was regarding child #1 falling outside on the cement.

During today's inspection, LPA’s interviewed staff regarding the unusual incident, reviewed personnel files, reviewed children’s files, collected facility records, and inspected play yard. After file review and interview it was determined that on 12/15/2022 there was a Site Supervisor as well as multiple fully qualified teachers and 19 children on site. Staff #1 indicated that child was running and slipped on the wet leaves. Staff #1 stated that after the incident maintenance staff came out and cleaned up the leaves. Recommendation by LPA’s made were to have staff remind children to walk and not run as well as inspect the play yard prior to going outside. Staff #1 confirmed that they scanned the play yard prior to use but would now also rake leaves if observed on the cement. Facility met all reporting requirements as specified in Title 22 Regulation 101212 - Reporting Requirements. The incident is an isolated incident and not a result of lack of care and supervision.

No deficiencies cited in the areas observed today.

This report is to be made available to the public upon request.
LIC 9213 Notice of Site Visit to be posted for 30 days.
SUPERVISORS NAME: Susie Fanning
LICENSING EVALUATOR NAME: Ruby Ocegueda
LICENSING EVALUATOR SIGNATURE: DATE: 01/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/19/2023
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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