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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103808816
Report Date: 01/10/2020
Date Signed: 01/10/2020 12:02:11 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:JULIA A. LOPEZ CHILD DEVELOPMENT CENTERFACILITY NUMBER:
103808816
ADMINISTRATOR:STEWART, SHEILAFACILITY TYPE:
850
ADDRESS:1300 SOUTH AVENUETELEPHONE:
(559) 626-6466
CITY:ORANGE COVESTATE: CAZIP CODE:
93646
CAPACITY:145CENSUS: 110DATE:
01/10/2020
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:50 AM
MET WITH:Sheila StewartTIME COMPLETED:
12:10 PM
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Licensing Program Analyst (LPA) Diana Martinez conducted an unannounced case management inspection to follow up on an unusual incident involving a day care child that occurred on 12/16/19, on the playground. LPA met with Program Director Sheila Stewart. The Unusual Incident Report (LIC 624) was received by Fresno Community Care Licensing on the following day, 12/17/19. The incident occurred when Child #1 (C1) ran and tripped over an exposed tree root. Upon tripping, C1 hit upper left eye near eye brow on nearby bench. Teacher-child ratio was in compliance when incident occurred, and Staff #1 was standing next to a bench adjacent to the bench C1 fell on. Child sustained an inch long cut and first aid was administered. Parent was contacted and child was taken to emergency room for treatment, which included stitches, on day of incident, 12/16/19. Immediately after incident, bench was moved to a different location and City came out the next day, 12/17/19, and removed the exposed tree root plus other smaller roots. C1 returned to facility on 12/2619, without restrictions or limitations as per clearance from doctor and is doing well. LPA observed the area where incident occurred and did not observe any tripping hazards as all tree roots were removed. This was an isolated incident and staff took appropriate measures to address the child’s injury following agency policies and procedures.

Per Title 22, Division 12, Chapter 1 of the California Code of Regulations, no deficiency is being cited.

Exit interview conducted with Program Director Sheila Stewart and a copy of this report was provided and discussed. A Notice of Site Visit Form (LIC 9213) was posted on parent's board and must remain posted for 30 days.
SUPERVISOR'S NAME: Michael DuarteTELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Diana D MartinezTELEPHONE: (559) 341-4670
LICENSING EVALUATOR SIGNATURE:

DATE: 01/10/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2020
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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