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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153809002
Report Date: 01/08/2020
Date Signed: 01/08/2020 12:07:45 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:LITTLE COUNTRY CHRISTIAN SCHOOLFACILITY NUMBER:
153809002
ADMINISTRATOR:JARRETT, REBECCAFACILITY TYPE:
850
ADDRESS:2408 DEAN AVETELEPHONE:
(661) 589-0501
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93312
CAPACITY:93CENSUS: 81DATE:
01/08/2020
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:10 AM
MET WITH:Rebecca Jarrett, DirectorTIME COMPLETED:
12:25 PM
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A case management inspection was conducted today by Licensing Program Analyst, Pete Espinoza. LPA met with, Rebecca Jarrett, Director, to discuss incident which occurred on 010/21/2019. A complete file review was conducted prior to visit. LPA toured facility inside and outside. Census was taken. LPA interviewed staff and observed area in which incident occurred.

Staff stated they were in 2's classroom with approximately 11 children at the time of the incident. Staff stated they observed child on floor complaining about her leg hurting. Staff stated child told them another child pushed her and she fell. Staff stated they did not observe child being pushed and/or falling. Staff assessed child and determined there were no major injuries. Staff stated child stopped complaining about her leg hurting shortly after and child ate lunch, napped and resumed classroom activities for the remainder of the day. Staff stated they called Mom at time of incident to inform her that child was complaining of her leg hurting and Mom told them she would wait until the end of the day to pick up her child. Staff stated when mom arrived at end of the day, child complained about her left arm hurting. Staff stated Mom took child to urgent care and then health provider who determined that child had a stress fracture to the left elbow. Child returned on 10/23 with arm in a sling and then a cast on 10/26. Staff provided copy of doctor's note indicating restrictions regarding limited outdoor play until 12/01/2019.

Teacher-Child ratio was reportedly in place when the incident took place. Based on the information obtained, this appears to be an isolated incident and Staff took appropriate measures to address the child's injury, following proper policies and procedures and no regulations were violated.

Per California Code of Regulations Title 22, Division 12, no deficiency cited during today's visit. Exit interview conducted with the Rebecca Jarrett, Director.

LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS.

To order forms, etc. visit our website at www.ccld.ca.gov.
SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Peter EspinozaTELEPHONE: 661-644-8231
LICENSING EVALUATOR SIGNATURE:

DATE: 01/08/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/08/2020
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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