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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 330911148
Report Date: 10/10/2024
Date Signed: 10/10/2024 02:43:12 PM

Document Has Been Signed on 10/10/2024 02:43 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
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:BERMUDA DUNES LEARNING CENTERFACILITY NUMBER:
330911148
ADMINISTRATOR/
DIRECTOR:		CLARK, GAYLEFACILITY TYPE:
850
ADDRESS:42115 YUCCA LANETELEPHONE:
(760) 772-7127
CITY:BERMUDA DUNESSTATE: CAZIP CODE:
92203
CAPACITY: 163TOTAL ENROLLED CHILDREN: 163CENSUS: 102DATE:
10/10/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:55 PM
MET WITH:Jennifer Nates TIME VISIT/
INSPECTION COMPLETED:
03:00 PM
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On 10/10/2024 at 1:55 pm, Licensing Program Analysts (LPAs) Gabriela Hernandez and Anastasia Flores conducted an unannounced case management visit in regard to an unusual incident report received on 10/10/2024 from Program Director Jean Espino. Program Director provided copy of UIR while LPA’s were on site completing annual inspection for school age and infant program.

Per incident report, Child 1 (C1) sustained an injury on 10/09/2024. LPAs interviewed S1 in the classroom where the incident occurred. Per S1, C1 was climbing on the box that stores all the emergency equipment. The emergency box is located at the entrance of the classroom. Per S1, C1 was facing the wall while standing on the box. Per S1, S3 had observed child standing on the box, simultaneously observed another child that was attempting to help C1 get down, when C1 fell on his back. C1 was comforted by teachers that were present. S1 stated they checked for any swelling and bruising, but did not see any on C1. Per S1, parents were notified of the incident. Per S1, incident occurred prior to lunch and nap time. Per S1, C1 is usually fussy around nap time so they were unsure if it was from the nap time or due to the fall. Per S1, C1 fell asleep, and they were checking on him constantly. Per S1, C1 woke up from the nap and they noticed he was still fussy. Per S1, they contacted parents to pick up C1. Program Director provided LPA with a copy of the ouch report confirming parents were notified. On 10/10/24, parents of C1 contacted the center and confirmed C1 had sustained a closed fracture below their shoulder. Per Program Director, C1 has not retuned to school and they have follow up meeting with parents today. Program Director confirmed they will update LPA with any updates.
Based on all the information obtained by LPAs, there did not appear to be any violations of Title 22 Regulations pertaining to the reported incident.

An exit an interview was conducted. A copy of this report and appeal rights were provided at the time visit. A notice of site visit was given and shall remain posted for 30 days.

SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: Gabriela Hernandez
LICENSING EVALUATOR SIGNATURE: DATE: 10/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/10/2024
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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