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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 100404094
Report Date: 07/29/2019
Date Signed: 07/29/2019 11:18:48 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-WEBSTER CHILD DEVELOPMENT CENTERFACILITY NUMBER:
100404094
ADMINISTRATOR:MADDEN, KATHERINE (KAY)FACILITY TYPE:
850
ADDRESS:930 N. AUGUSTATELEPHONE:
(559) 457-3000
CITY:FRESNOSTATE: CAZIP CODE:
93701
CAPACITY:66CENSUS: 19DATE:
07/29/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Charlotte MirandaTIME COMPLETED:
11:30 AM
NARRATIVE
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On this date, Licensing Program Analysts (LPAs) Angelica Slaughter and Ruby Ocegueda conducted an unannounced Case Management inspection. LPAs met with site supervisor Charlotte Miranda. The purpose of this inspection is to gather additional information regarding an incident that was reported on 07/23/19. The incident occurred on 07/19/19, but was reported after site supervisor returned to office on 07/23/19. It was reported that staff #1 put her hand over a child's mouth to muffle his cries. Child was heard saying, "Stop, you are hurting me." The incident occurred during nap time, approximately between 11:50 AM - 2:00 PM inside the classroom. LPAs reviewed documentation, interviewed staff who were present and the site supervisor. Documentation related to the incident was also collected.

Per California Code of Regulations, Title 22, Division 12, Chapter 1 the following deficiency is cited: (see next page LIC809D).

Exit interview was conducted. The Site Supervisor, Charlotte Miranda was provided a copy of their appeal rights and their signature on this form acknowledges receipt of this form.

* Any Licensing reports indicating a type A deficiency shall be posted immediately and for the next 30 days and copies provided of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. Health and Safety Section 1596.859(a) shall be cited and a civil penalty of $100.00 for failure to provide copies to parents/guardians of children in care and newly enrolled children, and for failure to maintain written verification of receipt of licensing reports indicating a Type A violation (LIC 9224).

A COPY OF THIS REPORT MUST REMAIN IN THE FACILITY FOR PUBLIC REVIEW. NOTICE OF SITE VISIT TO BE POSTED FOR 30 DAYS.

SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Angelica SlaughterTELEPHONE: (559) 341-3920
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: FUSD-WEBSTER CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 100404094
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/29/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/30/2019
Section Cited
CCR
101223(a)(3)
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Personal Rights. Each child shall be free from corporal or unusual punishment, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature. Staff #1 put her hand over a child's mouth to muffle his cries. Child was heard saying, "Stop, you are hurting me." This regulation
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Staff #1 has been placed on administrative leave pending outcome of internal investigation. Other staff who witnessed the incident have been met with and informed of proper reporting protocols. Deficiency cleared.
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was not met as evidenced by: interviews conducted with staff and written statements collected. This is an immediate risk to the health, safety and/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: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Angelica SlaughterTELEPHONE: (559) 341-3920
LICENSING EVALUATOR SIGNATURE:

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

DATE: 07/29/2019
LIC809 (FAS) - (06/04)
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