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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103801763
Report Date: 09/25/2019
Date Signed: 09/25/2019 11:14:04 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:KERMAN MIGRANT CENTERFACILITY NUMBER:
103801763
ADMINISTRATOR:HINOJOSA, ANAFACILITY TYPE:
850
ADDRESS:14660 W. G STREETTELEPHONE:
(559) 846-5351
CITY:KERMANSTATE: CAZIP CODE:
93630
CAPACITY:40CENSUS: 29DATE:
09/25/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Ana HinojosaTIME COMPLETED:
11:15 AM
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On this date, Licensing Program Analyst (LPA) Angelica Slaughter conducted an unannounced inspection to the facility. LPA and LPM met with Center Director, Ana Hinojosa. The purpose of today's inspection was to follow up on two incidents that were reported to Community Care Licensing (CCL) Fresno Regional Child Care Office. On 09/09/19, an incident report was made to the Duty Officer regarding Child #1 jumped off of a play structure referred to as a "Caterpillar" and hurt his foot. The day following the incident, Child #1 was limping and parents took child to the doctor to be evaluated. On 09/20/19, an incident report was made to the Duty Officer regarding Child #2. Babysitter of Child #2 advised center staff that Child #2 alleged that another child, Child #3 at the center touched her. Per Center Director, no staff has witnessed any inappropriate conduct between Child #2 and Child #3. LPA conducted a tour of the facility. Census for today was taken. A series of questions were asked regarding the incidents and they were discussed. Pictures were taken of the play structure referred to as a "Caterpillar". LPA also obtained copies of medical documents for Child #1.

Per California Code of Regulations Title 22 Chapter 22 Division 12 Chaper 3, there are no deficiencies being cited on this inspection.

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: 09/25/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2019
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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