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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103810200
Report Date: 01/28/2025
Date Signed: 01/28/2025 06:12:46 PM

Document Has Been Signed on 01/28/2025 06:12 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:LEARNING EXPERIENCE, THEFACILITY NUMBER:
103810200
ADMINISTRATOR/
DIRECTOR:		BETH NELSONFACILITY TYPE:
850
ADDRESS:2106 SHAW AVETELEPHONE:
(908) 887-5162
CITY:CLOVISSTATE: CAZIP CODE:
93611
CAPACITY: 120TOTAL ENROLLED CHILDREN: 113CENSUS: 104DATE:
01/28/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
04:01 PM
MET WITH:Brisa HernandezTIME VISIT/
INSPECTION COMPLETED:
06:20 PM
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On January 28, 2025, Licensing Program Analyst Miguel Herrera conducted an unannounced Case Management Inspection. LPA met with Curriculum Specialist, Brisa Hernandez. LPA toured the facility, and a census was taken. The purpose of today's inspection was regarding an Unusual Incident that occurred on 01/28/2025. The incident was regarding a child swinging on the facility's soccer goal posts and the goal posts flipping over landing on the child.

During today’s visit LPA Herrera conducted facility observations, interviewed staff, and reviewed facility records pertinent to the incident. LPA Herrera also obtained photographs of the outdoor play area and soccer goal posts. LPA Herrera will conduct additional interviews at a later date to gather further information pertinent to the incident.

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, no deficiencies are cited. Exit interview conducted with Curriculum Specialist, Brisa Hernandez. 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: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Miguel Herrera
LICENSING EVALUATOR SIGNATURE: DATE: 01/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/28/2025
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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