150406087-10-18-2019-04-CC-GRES-BH3MSS-20191018095222

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 150406087
Report Date: 10/03/2019
Date Signed: 10/18/2019 09:52:32 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:	CANYON HILLS PRESCHOOL		FACILITY NUMBER:	150406087
ADMINISTRATOR:	SARAH VINSON		FACILITY TYPE:	850
ADDRESS:	7001 AUBURN STREET		TELEPHONE:	(661) 871-0880
CITY:	BAKERSFIELD	STATE: CA	ZIP CODE:	93306
CAPACITY:	146	CENSUS: 69	DATE:	10/03/2019
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME BEGAN:	11:45 AM
MET WITH:	Sarah Vinson		TIME COMPLETED:	02:15 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	On this date, Licensing Program Analyst (LPA) Gloria Reyes met with Director, Sarah Vinson for an unannounced Case Management- Incident inspection. LPA toured the facility and a census was taken. An Unusual Incident Report was submitted to the Fresno Community Care Licensing Office regarding an incident that occurred on 09/13/19, at approximately 9:35 AM, child #1 was hit in mouth with a wooden block by child #2. Child #1, sustained a chipped tooth. On the day of the incident, LPA verified that there was 2 staff and 10 children present in the classroom. Child #2, was playing in the block area in the classroom. Child #1, walked over to the block area and took a block. Child #2, got upset and hit child #1 in the mouth with a block. Staff #1, was sitting at the kidney table when she observed child #2 raise his/her hand and the next second child #2 was holding his/her hand at his/her mouth. Staff #2, was at sitting at another table in front of child #1 and child #2 when the incident occurred. Staff #2, administered first aid and applied an ice pack on child #1's mouth. Child #1's parent was contacted and took the child to the dentist and x-rays confirmed that the nerve of the effected tooth was impacted. The parent was provided cream to put on the affected area in the mouth. The child was released, returned to the center and is doing fine. Today, LPA observed the area where the injury took place and LPA did not observe any hazards. The Director informed LPA that since the incident she has removed all wooden toys from all the classrooms. Also, the Director has a meeting scheduled on 10/17/19, to discuss with her staff "zone positions in the classroom" and "class rules and redirection of children". The Director will provide licensing with a copy of the training agenda and sign-in sheet. (see next page)

SUPERVISOR'S NAME: Alice Juarez	TELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Gloria Reyes	TELEPHONE: (559) 341-4471
LICENSING EVALUATOR SIGNATURE:	DATE: 10/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2019

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 2

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: CANYON HILLS PRESCHOOL	FACILITY NUMBER: 150406087
	VISIT DATE: 10/03/2019

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
26
27
28
29
30
31
32

This appears to be an isolated incident and staff took appropriate measures to address the child's injury following appropriate Agency policies and procedures.

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

An exit interview was conducted with Director, Sarah Vinson and a copy of this report was provided and discussed. A Notice of Site Visit Form was posted on parent's board and must remain posted for 30 days.

SUPERVISOR'S NAME: Alice Juarez	TELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Gloria Reyes	TELEPHONE: (559) 341-4471
LICENSING EVALUATOR SIGNATURE:	DATE: 10/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2019

LIC809 (FAS) - (06/04)

Page: 2 of 2