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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 100404093
Report Date: 07/29/2019
Date Signed: 08/05/2019 09:43:57 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:FUSD-SCANDINAVIAN CHILD DEVELOPMENT CENTERFACILITY NUMBER:
100404093
ADMINISTRATOR:MADDEN, KATHERINEFACILITY TYPE:
850
ADDRESS:3360 NORTH SIERRA VISTATELEPHONE:
(559) 457-3683
CITY:FRESNOSTATE: CAZIP CODE:
93726
CAPACITY:53CENSUS: 31DATE:
07/29/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:40 AM
MET WITH:Lead teacher Jennifer Goosey and Site Supervisor Jacque BurrellTIME COMPLETED:
11:50 AM
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An unannounced Case Management inspection was conducted at this preschool center by LPAs Patricia Musso and Candis Rodriguez today.
This Case Management inspection is being conducted because of an incident that was reported to CCL.

LPAs viewed the area where the incident occurred and viewed the water meter covers. The covers are made of cement and the crack on the cover of one, does
not appear to be the reason of the injury that occurred.

LPA Musso instructed Jennifer and Jacque to add something additionally (more cones, or Jacque said probably a table over the covers) on top and around the covers to help prevent an injury if a child were to fall where the covers are located. LPA Musso also instructed Jennifer and Jacque that a staff member should be positioned right in front of the covers to provide additional protection.

A work order was made right after the incident. Since nothing has been address in regards to the work order Jacques said she wrote another work order. She thinks
the orders might not be addressed until after August 5, 2019 due to vacations.

With the information received today, and per Title 22 of the California Code of Regulations no deficiency is cited today. This will be reviewed with CCL management.
During exit interview LPA viewed the provided LIC9213 being posted along
with instructions to post for 30 days.
SUPERVISOR'S NAME: Duane MatsubaraTELEPHONE: (559)650-7855
LICENSING EVALUATOR NAME: Patricia MussoTELEPHONE: (559) 341-5422
LICENSING EVALUATOR SIGNATURE:

DATE: 07/29/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2019
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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