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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 163907587
Report Date: 01/13/2023
Date Signed: 01/18/2023 08:29:58 AM

Document Has Been Signed on 01/18/2023 08:29 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:GONZALES, ESMERALDAFACILITY NUMBER:
163907587
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 6CENSUS: 1DATE:
01/13/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
08:10 AM
MET WITH:Esmeralda GonzalesTIME COMPLETED:
09:40 AM
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On 1/13/23, Licensing Program Analyst (LPA) Kathy Pacheco conducted an unannounced case management inspection. LPA met with Licensee Esmeralda Gonzales to discuss an incident that occurred on 12/8/22. LPA interviewed Licensee and observed the area where the incident occurred.

On 12/8/22 around 9:30 a.m., Licensee stated she was having circle time with the children. She said she walked across the room to get another book and child #1 (see Confidential Names Form (LIC 809) dated 1/13/23) crawled under a child's table that was placed in front of the electric fireplace and he touched the glass on the fireplace. Licensee said the electric fireplace had been turned off approximately 45 minutes prior to any children arriving at the day care. She said all of it happened very quickly and she went to child #1 immediately after it happened. Licensee said child #1's fingers were red and she immediately ran his hand under cold water and then applied coconut butter to the areas that were red. She said she called child #1's authorized representative later that morning and explained the incident and asked the authorized representative to pick up child #1. Licensee said child #1 was picked up by the authorized representative. Licensee said the authorized representative told her she took child #1 to the doctor the next day and they did not do anything to child #1 or prescribe anything for child #1. Licensee stated child #1 returned to the day care on 12/12/22 and there were no issues. Licensee stated since the incident occurred, if she does use the electric fireplace on mornings that she supervises day care children, then she is sure to turn the electric fireplace off at least one and a half hours prior to children arriving so the glass is cooler to the touch. Licensee said she still places the child's table in front of the electric fireplace to keep children from being near the area and she closely supervises the children around the electric fireplace area to avoid further incidents. LPA and Licensee also discussed reporting requirements of all unusual incident reports to Community Care Licensing (CCL) and parents and/or authorized representatives of children in care.

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SUPERVISORS NAME: Luisa Gavoutian
LICENSING EVALUATOR NAME: Kathy Pacheco
LICENSING EVALUATOR SIGNATURE: DATE: 01/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/13/2023
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 SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: GONZALES, ESMERALDA
FACILITY NUMBER: 163907587
VISIT DATE: 01/13/2023
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Based on the information obtained, LPA determined Licensee handled the incident correctly and reporting requirements were met. LPA further determined Licensee took appropriate measures to address child #1's injury and she followed proper policies and procedures and no regulations were violated.

Per California Code of Regulations Title 22, Division 12, no deficiency cited during today's inspection.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Licensee Esmeralda Gonzales.

SUPERVISORS NAME: Luisa Gavoutian
LICENSING EVALUATOR NAME: Kathy Pacheco
LICENSING EVALUATOR SIGNATURE:

DATE: 01/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2023
LIC809 (FAS) - (06/04)
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