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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 065401052
Report Date: 09/01/2021
Date Signed: 09/01/2021 11:14:28 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME:WILLIAMS PRESCHOOL LEARNING CENTER A AM/PM & BFACILITY NUMBER:
065401052
ADMINISTRATOR:MARKSS, VICKIFACILITY TYPE:
850
ADDRESS:1404 E STREET, ROOMS 134 & 135TELEPHONE:
(530) 473-2885
CITY:WILLIAMSSTATE: CAZIP CODE:
95987
CAPACITY:48CENSUS: 13DATE:
09/01/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Martha GarciaTIME COMPLETED:
11:15 AM
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On 9/1/2021 at 9:45am, Licensing Program Analyst (LPA) Laura Chavez conducted a Case Management inspection to the facility and met with Lead Teacher Martha Garcia in Room #135. The inspection was made in response to an unusual incident which was self reported to the Department on 8/20/2021. Division Director reported that on 8/20/2021 at approximately 9:25am during outdoor play time, Child #1 was climbing up on the climbing/swing structure when she fell and sustained a broken arm. Lead Teacher stated she observed Child #1 slip and fall from the second step of the spiral ladder, landing face down with both arms under her body. Lead Teacher said Child #1 cried and was holding her arm after falling from the play structure. Lead Teacher held Child #1's arm close to the child's body in order to immobilize it while Assistant Teacher #2 called the child's parents. LPA interviewed Child #1 and asked her to demonstrate what happened on the day she broke her arm. Child #1 pointed out to LPA the second step from where she slipped off the spiral ladder which was no more that 2' off the ground. During today's inspection, a physical plant inspection was conducted of the outdoor play area. LPA observed rubber playground padding under the climbing/swing structure. The structure meets the age requirements for preschool age children.

At this time, with the information available, it is determined that no violation of regulations resulted in the child's injury. This report was reviewed and discussed with Lead Teacher Martha Garcia. All licensing reports are public information and must be made available upon request.
Notice of Site Visit shall be posted for 30 days from today's visit.
SUPERVISOR'S NAME: Megan AvilesTELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Laura ChavezTELEPHONE: (530) 895-5914
LICENSING EVALUATOR SIGNATURE:

DATE: 09/01/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/01/2021
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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