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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 503808887
Report Date: 08/13/2024
Date Signed: 08/23/2024 08:36:59 AM

Document Has Been Signed on 08/23/2024 08:36 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 CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:SMALL WORLD CHRISTIAN SCHOOLFACILITY NUMBER:
503808887
ADMINISTRATOR/
DIRECTOR:		PADILLA, MIRIAMFACILITY TYPE:
850
ADDRESS:1024 6TH STREETTELEPHONE:
(209) 523-4388
CITY:MODESTOSTATE: CAZIP CODE:
95354
CAPACITY: 74TOTAL ENROLLED CHILDREN: 35CENSUS: 28DATE:
08/13/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:30 AM
MET WITH:Debrah MartinezTIME VISIT/
INSPECTION COMPLETED:
11:30 AM
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On August 13, 2024, Licensing Program Analysts (LPAs), Yesenia Fierro and Nohemi Sanchez conducted an unannounced Case Management – Incident inspection. LPAs met with Site Supervisor Debrah Martinez. LPAs toured the facility, and a census was taken. An Unusual Incident Report was recently reported to the Fresno Community Care Licensing Office regarding an incident that occurred at the facility on August 5, 2024, where Staff 1 observed Staff 2 forcefully hold child 1 down on the cot to nap and forcefully hit child 1 on the head.

The purpose of this inspection was to investigate the above-mentioned occurrence. Today, LPAs spoke with Site Supervisor Debrah Martinez, conducted observations, and interviewed Staff 1(S1) and Child 1 (C1).

S1 indicated she saw S2 holding the door to the nap room, when C1 ran in, S1 stated she saw S2 go after C1 and hit him multiple times on the head. LPAs spoke to C1, C1 shared that S2 pushed him to his bed and hit him on his head and that it hurt him.

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, the following deficiency is being cited: (see next page, LIC 809 D).

LPA Fierro informed Site Supervisor Debrah Martinez that this report dated 8/13/2024 documents one Type A citation, which shall be posted for 30 consecutive days as there was an immediate risk to the health, safety, or personal rights of children in care.

CON'T 809-C

SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Yesenia Fierro
LICENSING EVALUATOR SIGNATURE: DATE: 08/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/13/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: SMALL WORLD CHRISTIAN SCHOOL
FACILITY NUMBER: 503808887
VISIT DATE: 08/13/2024
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Also, LPA Fierro informed Site Supervisor Debrah Martinez to provide a copy of this licensing report dated 8/13/2024 that documents a Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Reports (LIC 9224), or other written statement, must be placed in the child's file for verification. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.


Site Supervisor Debrah Martinez was provided a copy of appeal rights. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Site Supervisor Debrah Martinez.
SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Yesenia Fierro
LICENSING EVALUATOR SIGNATURE:

DATE: 08/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 08/23/2024 08:36 AM - It Cannot Be Edited


Created By: Yesenia Fierro On 08/13/2024 at 10:33 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: SMALL WORLD CHRISTIAN SCHOOL
FACILITY NUMBER: 503808887

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/13/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/23/2024
Section Cited
CCR
101223(a)(1)(3)

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(a) The licensee shall ensure that each child is accorded the following personal rights: (1) To be accorded dignity in his/her personal relationships with staff and other persons. (3) To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse
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Site Supervsior stated a staff meeting will be conducted and personal rights will be reviewed. ALL staff will TYPE ONE PAGE 12 FRONT TIME NEW ROMAN on what is considered a personal rights violation. LPA will met with ALL staff and conduct a training.
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or other actions of a punitive nature including but not limited to…This requirement was not met as evidenced by: Based on interviews conducted it was determined that S2 hit C1 on the head multiple times. Staff 1 violated the personal rights of those in care. This poses a potential risk to the health, safety, or personal rights of children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Juvenal Moctezuma
LICENSING EVALUATOR NAME:Yesenia Fierro
LICENSING EVALUATOR SIGNATURE:
DATE: 08/13/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/13/2024


LIC809 (FAS) - (06/04)
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