103808384-1-22-2020-04-CC-LGAN-BL42RL-20200122163743

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 103808384
Report Date: 01/22/2020
Date Signed: 01/22/2020 04:37:45 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:	SOUTHEAST FRESNO CHILD DEVELOPMENT CENTER		FACILITY NUMBER:	103808384
ADMINISTRATOR:	LAM, KUNTHEAR		FACILITY TYPE:	840
ADDRESS:	5191 E. TULARE		TELEPHONE:	(559) 252-6445
CITY:	FRESNO	STATE: CA	ZIP CODE:	93727
CAPACITY:	30	CENSUS: 14	DATE:	01/22/2020
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Director - Tia Lam		TIME COMPLETED:	04:45 PM

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On this date, Licensing Program Analyst (LPA) Luisa Gavoutian conducted a case management inspection. LPA met with Director/Owner Tia Lam to discuss the incident that was reported to Community Care Licensing (CCL) on 01/14/2020.

The incident involved Child 1 needing medical attention on the night of 01/02/2020 for low blood sugar. LPA interviewed Director Tia and verified that the incident did not occur during daycare hours of operation. Records review indicate that Child 1 was not in care at the facility on that date. Furthermore, the facility does not maintain a plan for providing Incidental Medical Services (IMS) and no arrangement had been made with the child’s parent/authorized representative to administer medication.

No deficiency cited during this inspection.

A copy of this report must be made available upon request.

LIC9213 Notice of Site Visit to be posted for 30 days.

SUPERVISOR'S NAME: Alice Juarez	TELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Luisa Gavoutian	TELEPHONE: (559) 341-4725
LICENSING EVALUATOR SIGNATURE:	DATE: 01/22/2020

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/22/2020

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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