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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 243801874
Report Date: 05/12/2023
Date Signed: 05/12/2023 01:33:17 PM

Document Has Been Signed on 05/12/2023 01:33 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, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:WALNUT CHILD DEVELOPMENT CENTERFACILITY NUMBER:
243801874
ADMINISTRATOR:KHOSLA, MANISHAFACILITY TYPE:
850
ADDRESS:2600 WALNUT AVENUETELEPHONE:
(209) 394-5440
CITY:LIVINGSTONSTATE: CAZIP CODE:
95334
CAPACITY: 96TOTAL ENROLLED CHILDREN: 96CENSUS: 27DATE:
05/12/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Manisha KhoslaTIME COMPLETED:
02:00 PM
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On 5/12/23, Licensing Program Analyst (LPA) Priscilla Zamudio arrived at the facility to conduct an unannounced Case Management inspection. LPA met with Director, Manisha Khosla. LPA toured the facility and a census was taken. The purpose of today's inspection was regarding an unusual incident that was reported to the Fresno Childcare Regional Office on 4/24/23. On 4/19/23, Child #1 was climbing a play structure in the playground when she slipped and hurt herself on the ledge of the structure.

During today’s inspection, LPA conducted a file review of Staff #1 and Child #1. Staff was interviewed and LPA observed and took photos of the area where the child was injured on the play structure. Staff reported being near the child the entire time and was able to catch the child, avoiding further injury. Staff stated they also met with the parent to demonstrate and explain how the incident occurred. Documentation on file showed the parent’s signature of the incident report received on 4/19/23. There have been no further issues and staff continue to stand within arms reach when a child climbs the particular area of the structure.

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, no deficiencies are cited.

Exit interview conducted and report was reviewed with Director, Manisha Khosla.

This report shall be made available to the public upon request. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Cynthia Brannon
LICENSING EVALUATOR NAME: Priscilla Zamudio
LICENSING EVALUATOR SIGNATURE: DATE: 05/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/12/2023
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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