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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 100404961
Report Date: 12/27/2019
Date Signed: 12/27/2019 12:39:08 PM

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:KIDS KARE RIVER PARKFACILITY NUMBER:
100404961
ADMINISTRATOR:CHANNITA, BARBARAFACILITY TYPE:
850
ADDRESS:7311 N. FIRSTTELEPHONE:
(559) 431-2566
CITY:FRESNOSTATE: CAZIP CODE:
93710
CAPACITY:95CENSUS: 42DATE:
12/27/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Deana JackTIME COMPLETED:
12:45 PM
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On this date, Licensing Program Analyst (LPA) Robert Gutierrez met with Assistant Director Cristina Perez, for an unannounced case management - incident inspection. LPA toured the facility and a census was taken. An Unusual Incident Report was submitted to the Fresno Community Care Licensing Office (CCL) regarding an incident that occurred on December 19, 2019, in which Child #1 was not feeling well, put his/her head down to rest on teacher Olivia Urbieta and was observed to be unresponsive by staff. During the time of the incident Child #1 was sitting at the table coloring with Ms. Urbieta. While coloring Child #1 started to lean on Ms. Urbieta to rest. Ms. Urbieta leaned over to ask Child #1 how he/she was doing. While checking on Child #1 Ms. Urbieta noticed he/she was unresponsive. During the time of the incident Child #1 legal guardian arrived at the facility and tended to him/her. Child was taken home and later went to the doctor. Child #1 has returned to the facility.

Since the time of the incident staff have implemented steps and procedures to prevent this event occurring with Child #1. During time of incident LPA reviewed the steps and procedures.

This appears to be an isolated incident and staff took appropriate measures to ensure that the personal rights of all children in care are being protected, on a continuous basis.

Per California Code of Regulations, Title 22, Division 12, Chapter 1, no deficiency was cited during today's visit.

An exit interview conducted with Assistant Director Cristina Perez and a copy of this report was provided and discussed. A Notice of Site Visit Form was posted on parent's board and must remain posted for 30 days.
SUPERVISOR'S NAME: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Robert GutierrezTELEPHONE: 559-243-4588
LICENSING EVALUATOR SIGNATURE:

DATE: 12/27/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/27/2019
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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