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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153910605
Report Date: 11/07/2022
Date Signed: 11/07/2022 10:33:33 AM

Document Has Been Signed on 11/07/2022 10:33 AM - 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 SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:SALGADO, MARTHA FAMILY CHILD CAREFACILITY NUMBER:
153910605
ADMINISTRATOR:SALGADO, MARTHAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 309-7288
CITY:WASCOSTATE: CAZIP CODE:
93280
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 4DATE:
11/07/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Martha Salgado, LicenseeTIME COMPLETED:
10:45 AM
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On 11/07/2022, a Case Management inspection was conducted today by Licensing Program Analyst, Pete Espinoza (LPA). LPA met with Martha Salgado, Licensee, to discuss incident which occurred on 10/25/2022. A complete file review was conducted prior to visit. LPA toured facility inside and outside. Census was taken. LPA interviewed staff and observed area in which incident occurred.

Licensee stated on the morning of the incident a child enrolled in daycare appeared weak and "out of it". Licensee stated child appeared to be limp and crying with his eyes closed. Licensee stated she called ambulance and then called parent. Licensee stated ambulance arrived shortly and then parent arrived. Licensee ambulance took child in ambulance to hospital. Licensee stated child was sent to Children's Hospital in Madera with intestinal issues. Licensee stated child was treated and released from hospital a few days later. Licensee stated child has not returned to daycare.

Based on the information obtained, this appears to be an isolated incident and Licensee 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 Martha Salgado, Licensee.

LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS.

To order forms, etc. visit our website at www.ccld.ca.gov.
SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Peter Espinoza
LICENSING EVALUATOR SIGNATURE: DATE: 11/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/07/2022
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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