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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 163808397
Report Date: 12/04/2024
Date Signed: 12/04/2024 09:03:47 AM

Document Has Been Signed on 12/04/2024 09:03 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 RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:LEMOORE GENERATION CENTERFACILITY NUMBER:
163808397
ADMINISTRATOR/
DIRECTOR:		ENRIQUEZ, CARLAFACILITY TYPE:
850
ADDRESS:1075 BLAKE STREETTELEPHONE:
(559) 925-1502
CITY:LEMOORESTATE: CAZIP CODE:
93245
CAPACITY: 76TOTAL ENROLLED CHILDREN: 76CENSUS: 0DATE:
12/04/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
07:27 AM
MET WITH:Gloria VelezTIME VISIT/
INSPECTION COMPLETED:
09:10 AM
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On December 4, 2024, Licensing Program Analyst (LPA) Paul Garcia met with Assistant Site Supervisor Gloria Velez for an unannounced case management inspection. LPA toured the facility inside and outside, and a census was taken. The purpose of today's inspection was to follow up on an unusual incident that was reported to Community Care Licensing Office where child 1 (C1) sustained an injury requiring medical treatment.

The Unusual Incident Report submitted to CCL pertained to an incident that occurred on November 15, 2024, involving a child at play that collided while running into a stationary play tunnel with enough force to create a laceration inside his/her mouth.

Today, LPA spoke with Assistant Site Supervisor Gloria Velez regarding the incident. First aid was provided, and the child's parent was notified. The child was taken to Adventist Health the same day where child’s lip was evaluated and treated with glue. Child was released without any restrictions and returned to care the very next day.

Today, LPA observed the outdoor play area where the incident took place. The play equipment observed appeared to be age appropriate. On the day of the incident, there were two (2) supervisors providing care and supervision to the children outdoors when the incident occurred; therefore, adequate ratios were in place. Assistant Site Supervisor Gloria Velez stated that staff ensures that adequate care and supervision is provided to all children in care.

Based on the information obtained, LPA determined the licensee handled the incident correctly and reporting requirements were met. LPA determined that the licensee took appropriate measures to address the incident, following both internal policy and Title 22 Regulations. Per California Code of Regulations, Title 22, Division 12, no deficiency was cited during today's inspection. A notice of site visit was given and must remain posted for 30 days. Exit interview was conducted and report was reviewed with Assistant Site Supervisor Gloria Velez.
SUPERVISORS NAME: Gloria Reyes
LICENSING EVALUATOR NAME: Paul Garcia
LICENSING EVALUATOR SIGNATURE: DATE: 12/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/04/2024
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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