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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153908554
Report Date: 01/17/2020
Date Signed: 01/17/2020 02:26:44 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:SAMAYOA, SANDRA FAMILY CHILD CAREFACILITY NUMBER:
153908554
ADMINISTRATOR:SAMAYOA, SANDRAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 379-5921
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93307
CAPACITY:14CENSUS: 0DATE:
01/17/2020
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Sandra SamayoaTIME COMPLETED:
02:45 PM
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Licensing Program Analyst (LPA) Jose Penate conducted a Case Management Incident inspection for an incident which occurred on 01/14/2020. LPA met with Licensee, Sandra Samayoa and assistant. LPA toured facility inside and outside and took census.

On 01/14/2020 licensee reported an incident that occurred in driveway of the facility. Parent was dropping off her three children they exited the vehicle, while parent remained in the vehicle. Parent assumed all three children had walked to the facility entry door and backed her vehicle, running over one of her children who was behind the vehicle. Licensee and husband heard screaming, at which point they ran out and discovered child pinned under the vehicle. Licensee’s husband had to move the vehicle that had child pinned under due to parent of child being distraught. Parent of the child brought him into the home, where he regained consciousness. The neighbor contacted 9-1-1 and Bakersfield Police Department, licensee also contacted paramedics but the call was already made by another party. Child was rushed to the hospital. Parent accepted blame for accident.

Licensee stated that normal practice is for every parent is to come inside and sign child in for daycare. On this day parent was running late and just dropped off children, telling them to exit the vehicle and go inside the facility. Licensee assumed children were at the door with the parent but unfortunately the licensee just heard all the yelling and screaming coming from outside due to the incident.

Licensee stated that they will make it MANDATORY for every parent to come in the facility and sign the child in and sign them out. No parent will be allowed to just drop off the children and have them go to the door on their own.

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

Site Visit Notice posted on the parent board. Exit interview was conducted with Licensee, Sandra Samayoa.

SUPERVISOR'S NAME: Michael DuarteTELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Jose PenateTELEPHONE: (559) 341-5860
LICENSING EVALUATOR SIGNATURE:

DATE: 01/17/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2020
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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