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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153808480
Report Date: 05/10/2022
Date Signed: 05/10/2022 02:27:31 PM

Document Has Been Signed on 05/10/2022 02:27 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
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:PETE H. PARRA CHILD DEVELOPMENT CENTERFACILITY NUMBER:
153808480
ADMINISTRATOR:DODD, ESTHERFACILITY TYPE:
850
ADDRESS:1825 FELIZ DRIVETELEPHONE:
(661) 831-5915
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93307
CAPACITY: 96TOTAL ENROLLED CHILDREN: 96CENSUS: 40DATE:
05/10/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Yesenia Rubira, Site SupervisorTIME COMPLETED:
02:30 PM
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On 05/10, Licensing Program Analyst (LPA) conducted a case management visit for unusual incident reported on 03/24/2022 regarding a child who had fell in grass area resulting in an injury. LPA met with Esther Dodd, Site Supervisor, toured facility inside and outside. Census was taken. LPA interviewed staff and observed area in which incident occurred.

Staff stated on 03/23/2022, there were two (2) staff outside in play area with 5 children. staff stated they were with children in assigned areas when one child walked across play area, tripped over balance beam and fell on his hands. Staff stated they immediately applied first aide with an ice pack and called parent. Staff stated parent arrived shortly and took child to urgent care. Staff stated child was diagnosed with bruised wrist and returned to center on 03/25/2022.

Teacher-Child ratio was reportedly in place when the incident took place. Based on the information obtained, this appears to be an isolated incident and Staff took appropriate measures to address the child's injury, following proper policies and procedures and no regulations were violated.

Per California Code of Regulations Title 22, Division 12, no deficiency cited during today's visit. Exit interview conducted with the Yesenia Rubira, Site Supervisor.

LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS.
SUPERVISORS NAME: Diana deLeon
LICENSING EVALUATOR NAME: Peter Espinoza
LICENSING EVALUATOR SIGNATURE: DATE: 05/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/10/2022
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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