<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 100406443
Report Date: 09/24/2019
Date Signed: 09/24/2019 12:04:43 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:FUSD-WILSONFACILITY NUMBER:
100406443
ADMINISTRATOR:MADDEN, KATHERINEFACILITY TYPE:
850
ADDRESS:2131 W. ASHLANTELEPHONE:
(559) 457-3683
CITY:FRESNOSTATE: CAZIP CODE:
93705
CAPACITY:24CENSUS: 18DATE:
09/24/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Carolyn RamosTIME COMPLETED:
12:15 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analysts (LPAs) Angelica Mejia and Robert Gutierrez, conducted a case management inspection today. The purpose of today's visit was to further investigate an incident which occurred on 8/22/2019. LPAs met with Teacher Carolyn Ramos. LPAs toured the facility inside and outside and a census was taken.

LPAs spoke with staff regarding the incident on 8/22/2019. Ms. Ramos stated that the children were out on the playground during morning recess at approximately 8:55 a.m., when Child #1 tripped on their own feet while running on the rubber play area. Child #1 fell forward and put both hands out in front resulting in a fracture to the child’s right arm near the elbow. There were three staff and approximately 18 children out on the playground at the time of the incident. LPAs inspected the area of the rubber flooring where the incident occurred and the complete play structure for any hazards. LPAs noted a different section of the rubber flooring with a dip in the middle of two tiles. The area was marked with an orange caution cone.

Ms. Ramos states that district Early Learning Licensing Liaison, Mary Anne Moreno, met with Facilities staff and the playground manufacturer the week following the incident to inspect the playground area. Staff inspected the area where the incident occurred as well as an area of the rubber flooring that has two tiles with a depression. Staff are working with the manufacturer to correct the area with the depression.

Ms. Ramos continues to work with the children regarding safety rules while on the playground. She reminds them to be mindful of others while running or playing. The staff maintains ratio and assigns zones to each staff member while on the playground with children present.

No deficiencies were noted.
BASED UPON INFORMATION THAT WAS OBTAINED FROM THE FACILITY STAFF, IT IS DETERMINED THAT THERE WERE NO VIOLATIONS OF THE CCL REGULATIONS. NO FURTHER ACTION IS REQUIRED AT THIS TIME.
Site Visit Notice posted. Exit interview was conducted.
SUPERVISOR'S NAME: Duane MatsubaraTELEPHONE: (559) 650-7855
LICENSING EVALUATOR NAME: Angelica MejiaTELEPHONE: (559) 341-6126
LICENSING EVALUATOR SIGNATURE:

DATE: 09/24/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 1