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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103810200
Report Date: 02/03/2025
Date Signed: 02/03/2025 01:10:10 PM

Document Has Been Signed on 02/03/2025 01:10 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: 112CENSUS: 86DATE:
02/03/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:21 AM
MET WITH:Beth NelsonTIME VISIT/
INSPECTION COMPLETED:
01:25 PM
NARRATIVE
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On February 3, 2025, Licensing Program Analyst Miguel Herrera conducted an unannounced Case Management Inspection. LPA met with Director, Beth Nelson. 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 hanging on the facility's soccer goal net and the goal posts flipping over and landing on the child.

During today’s visit LPA Herrera conducted facility observations, interviewed staff, and reviewed facility records pertinent to the incident. Based on interviews and records review, LPA Herrera confirmed, that while playing in the facility’s sports yard child #1 sustained an injury that required medical attention. Per interviews, the child was hanging from the soccer goal net and the goal posts flipped over and landed on the child. Per interviews and observations, the soccer goal posts were not properly secured and anchored to the ground at the time of the incident therefore the soccer goal posts flipped over. During the inspection LPA Herrera observed warning labels on the goal posts, warning about the risk of the soccer goal posts falling over if not properly secured. Furthermore, the warning labels also stated to never climb on the goal posts/nets and that the goal posts should be securely anchored at all times.

Through interviews and records review, it was determined that the incident was an isolated incident. Although the facility followed appropriate reporting requirements and took appropriate measures to address the incident, the facility did not provide children safe equipment as the goal posts were not properly secured and anchored to the ground as instructed by the manufacture’s warnings, which posed an immediate risk to children in care (see LIC 809-D Type A deficiency).

Report continued on LIC 809-C.

SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Miguel Herrera
LICENSING EVALUATOR SIGNATURE: DATE: 02/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/03/2025
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: LEARNING EXPERIENCE, THE
FACILITY NUMBER: 103810200
VISIT DATE: 02/03/2025
NARRATIVE
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Exit interview conducted and report was reviewed with Director Beth Nelson. Appeal rights were provided. Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, the following deficiency is being cited: (see LIC. 809-D). Upon receipt of a Type A violation, 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. A copy of the Fact Sheet - Child Care Parent Notification Requirements and a copy of LIC 9224 Acknowledgement of Receipt of Licensing Reports was given to Director, Beth Nelson. This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.
SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Miguel Herrera
LICENSING EVALUATOR SIGNATURE:

DATE: 02/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2025
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 02/03/2025 01:10 PM - It Cannot Be Edited


Created By: Miguel Herrera On 02/03/2025 at 11:24 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: LEARNING EXPERIENCE, THE
FACILITY NUMBER: 103810200

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/03/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/04/2025
Section Cited
CCR
101223(a)(2)

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(a) The licensee shall ensure that each child is accorded the following personal rights:
(2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs.
This requirement was not met evidenced by:
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Director Nelson immediately made the soccer goal posts inaccessible to children by moving them away from the outdoor play area and storing the goal posts in the facility’s parking lot. Furthermore, Director Nelson will provide staff training regarding zoning and areas deemed as “hot spots” for accidents.
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Based on interviews and document review, Child #1 sustained an injury while in care that required medical attention. Per interviews, child #1 was hanging from the soccer goal nets and the goal posts flipped and landed on the child. Per interviews, the goal posts were not secured and anchored to the ground during the incident, which posed an immediate risk to the health, safety, and personal rights of children in care.
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Director Nelson will provide a copy of the attendance list along with the training material to CCLD Fresno by POC deadline.

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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:Juvenal Moctezuma
LICENSING EVALUATOR NAME:Miguel Herrera
LICENSING EVALUATOR SIGNATURE:
DATE: 02/03/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/03/2025


LIC809 (FAS) - (06/04)
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