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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543810130
Report Date: 05/22/2024
Date Signed: 05/22/2024 03:42:35 PM

Document Has Been Signed on 05/22/2024 03:42 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 SOUTH CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:BOINGOS ACADEMYFACILITY NUMBER:
543810130
ADMINISTRATOR/
DIRECTOR:
LOIS LOPEZFACILITY TYPE:
850
ADDRESS:7137 W PERSHING CTTELEPHONE:
(559) 623-9206
CITY:VISALIASTATE: CAZIP CODE:
93291
CAPACITY: 69TOTAL ENROLLED CHILDREN: 69CENSUS: 65DATE:
05/22/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:45 PM
MET WITH:Alyssa CeballosTIME VISIT/
INSPECTION COMPLETED:
04:00 PM
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On May 22, 2024, Licensing Program Analysts (LPA’s) Christopher Burnias and Kari McWilliams conducted an unannounced case management inspection. LPA’s toured the facility and a census was taken. LPA’s met with Licensee Alyssa Ceballos and informed Licensee Ceballos of the purpose of today’s inspection.

On May 21, 2024 it was reported to the Fresno South Regional office that on May 21, 2024 that Child #1 (C1) was playing outside on the little slide when he jumped off of the slide. It is reported that C1 went to Staff #1 (S1) reported that his arm hurts. S1 communicated with Staff #2 (S2) who informed Licensee. S2 brought child inside and applied ice. Licensee contacted mom who instructed Licensee to call 911. Emergency Medical Services (EMS) came to assess the child’s injury and the child was taken to hospital where it was determined that the child’s arm was broken. Medical staff was able to stabilize C1’s arm and place the arm back into place. EMS placed a temporary splint on child’s arm and C1 has appointment on 06/04/24 with a surgeon to determine whether surgery is needed or not.

It was reported that 22 children and 4 staff members were present during the time of the incident.

During today’s inspection LPA inspected the outdoor play area including the slide. LPA requested facility documentation and interviewed staff.

Per California Code of Regulations Title 22, Division 12, Chapter 1, no deficiency is cited today. Exit interview conducted and report reviewed with Licensee Alyssa Ceballos. Notice of Site was provided and required to be posted for thirty days.

SUPERVISORS NAME: Luisa Gavoutian
LICENSING EVALUATOR NAME: Christopher Burnias
LICENSING EVALUATOR SIGNATURE: DATE: 05/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/22/2024
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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