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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103810185
Report Date: 01/23/2024
Date Signed: 01/23/2024 12:54:42 PM

Document Has Been Signed on 01/23/2024 12:54 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:FEOC RICHARD KEYES HEAD STARTFACILITY NUMBER:
103810185
ADMINISTRATOR:ALCORTA, GUADALUPEFACILITY TYPE:
850
ADDRESS:1620 W FAIRMONT AVETELEPHONE:
(559) 263-1205
CITY:FRESNOSTATE: CAZIP CODE:
93705
CAPACITY: 80TOTAL ENROLLED CHILDREN: 80CENSUS: 41DATE:
01/23/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Shawna Wilbourn - Family Community Service LiasonTIME COMPLETED:
01:30 PM
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On 01/23/2024, Licensing Program Analyst (LPA) Valerie Mireles met with Head Teacher/ Interim Director Shelly Federico for an unannounced Case Management Inspection. A file review was conducted prior to today's inspection. LPA toured the facility and a census was taken. LPA observed a total of 41 children separated by four classrooms; Room 1 consisted of 12 children, Room 2 consisted of 15 children, Room 3 consisted of nine children and Room 4 consisted of five children. The purpose of today's inspection was to address an unusual incident that took place at the facility on 12/14/2023.

An Unusual Incident Report was submitted to the Fresno Community Care Licensing (CCL) Office regarding an incident that occurred on 12/14/2023 involving a daycare child that sustained an injury to the head while playing on the outdoor climbing structure. On 01/23/2024, LPA spoke with Shelly Federico and Staff #2, who reportedly witnessed the incident as it occurred. According to the staff, the child was climbing up the stairs of the outdoor climbing structure, leaned over and the child’s head hit the pole. The child sustained a 0.5 inch cut across the right side of the child’s forehead. Staff #2 rendered aid and the child requested to continue to play. The child’s parent was notified immediately. Per Shelly Federico, the child was taken to the emergency room, saw a physician on the date of the incident and was given one stitch. The incident occurred on the last day before winter break; therefore, no special accommodations were needed for the child.

On 01/23/2024, LPA observed the outdoor play structure where the incident took place. The outdoor play structure was inspected and was in good condition with no visible defects. At the time of the incident there were two staff present, including one fully qualified, CPR certified teacher and approximately 11 children present; therefore, adequate supervision was in place. After interviewing staff and reviewing facility records, LPA determined facility staff took appropriate measures to address the child’s injury, reporting requirements were met, following proper policies and procedures and no regulations were violated.

Per the California Code of Regulations, Title 22, Division 12, Chapter 1, no deficiency was cited during today’s inspection. Exit interview conducted with the Head Teacher/ Interim Director, Shelly Federico.

SUPERVISORS NAME: Cynthia Brannon
LICENSING EVALUATOR NAME: Valerie Mireles
LICENSING EVALUATOR SIGNATURE: DATE: 01/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/23/2024
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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