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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103808844
Report Date: 10/25/2024
Date Signed: 10/25/2024 02:49:29 PM

Document Has Been Signed on 10/25/2024 02:49 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:FUSD-LAVERA WILLIAMS EARLY LEARNING CENTERFACILITY NUMBER:
103808844
ADMINISTRATOR/
DIRECTOR:
MATHIES, DEANNAFACILITY TYPE:
850
ADDRESS:1015 FRESNO STREETTELEPHONE:
(559) 457-3690
CITY:FRESNOSTATE: CAZIP CODE:
93706
CAPACITY: 98TOTAL ENROLLED CHILDREN: 98CENSUS: 44DATE:
10/25/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:15 PM
MET WITH:Veronica RamosTIME VISIT/
INSPECTION COMPLETED:
03:05 PM
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On 10/25/2024, Licensing Program Analyst (LPA) Xona Xayavong arrived at the facility to conduct an unannounced Case-Management-Incident inspection. LPA met with Site Supervisor Veronica Ramos. LPA explained that the reason for the visit was to account for an unusual incident.

An unusual incident report was submitted to the Fresno Regional Office regarding an incident that occurred on 10/14/2024, approximately at 11:50 am in the Toddler Classroom 2, while students were getting ready to wash their hands after lunch and C1 slipped and fell. C1 hit his left arm on the sink. S2 witnessed the incident stated C1 was in the process of throwing himself. S2 stated C1 did cried after the fall and was taken outside because other students were going inside. S3 notified Site Supervisor then Site Supervisor notified mother of the incident. On 10/15/2024, mother took C1 to the doctor and was informed C1 sustained a sprained elbow.

During today’s inspection, LPA conducted staff interviews. LPA determined staffs took appropriate actions with supervision, providing first aid, and reporting requirement. Licensee has replaced the stepping stool with a non-slip wooden stepping stool and licensee will conduct training with staff on dealing with children with difficult behavior on 11/15/2024.

Based on the interviews, LPA Xayavong was able to determine that the facility met the child’s health and safety and personal rights.

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, no deficiencies are cited.

Exit interview conducted with Site Supervisor Veronica Ramos. Appeal rights were provided. This report is to be made available to the public upon request. LIC 9213 Notice of Site Visit to be posted for 30 days.

Kari McWilliamsTELEPHONE: (559)341-5422
Xona XayavongTELEPHONE: (559) 320-9885
DATE: 10/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/25/2024
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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