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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103801766
Report Date: 11/27/2023
Date Signed: 11/27/2023 04:46:47 PM

Document Has Been Signed on 11/27/2023 04:46 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
FRESNO CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:WILSON PRESCHOOLFACILITY NUMBER:
103801766
ADMINISTRATOR:LORI WELCHFACILITY TYPE:
850
ADDRESS:504 FALLERTELEPHONE:
(559) 524-6959
CITY:SANGERSTATE: CAZIP CODE:
93657
CAPACITY: 90TOTAL ENROLLED CHILDREN: 90CENSUS: 28DATE:
11/27/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Sandra OlivoTIME COMPLETED:
05:00 PM
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On 11/27/2023, Licensing Program Analyst (LPA) Aurelio Mendoza conducted an unannounced case management inspection. LPA met with Coordinator of Early Education Sandra Olivo to discuss an unusual incident which occurred on 10/12/2023. On 10/12/2023 child #1 was playing on a children’s play structure and while walking up tripped resulting in child # 1 hitting their chin on the third step of the play structure. Staff # 1 and Staff # 2 quickly assisted and walked the child to the nurse’s area where first aid was provided that stopped child #1’s chin from bleeding. Staff contacted child #1’s parent where they arrived within ten minutes of the incident. Per parent’s direction 911 was called and both child #1 and parent were escorted via ambulance to a local hospital. Upon receiving care at the hospital, child #1 was released to return to school on 10/13/2023 per medical note however at parent’s discretion was kept home longer for healing and child #1 returned to care at the facility on 10/23/2023.

A complete file review was conducted prior to visit. LPA toured facility inside and outside. LPA took a census, interviewed staff, and observed area in which incident occurred.

Based on the information obtained, LPA determined facility staff handled the incident correctly. LPA determined facility staff took appropriate measures to address the child's injury, followed proper policies and procedures and no regulations were violated.



Per California Code of Regulations Title 22, Division 12, no deficiency cited during today's inspection.

LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS.
SUPERVISORS NAME: Cynthia Brannon
LICENSING EVALUATOR NAME: Aurelio Mendoza
LICENSING EVALUATOR SIGNATURE: DATE: 11/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/27/2023
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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