163801067-4-27-2023-57-CC-CROZ-CRAQMM-20230427121745

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 163801067
Report Date: 04/27/2023
Date Signed: 04/27/2023 12:17:51 PM

Document Has Been Signed on 04/27/2023 12:17 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 SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME:	PRESTON J. GREEN, SR., LEARNING CENTER		FACILITY NUMBER:	163801067
ADMINISTRATOR:	SIBRIAN, BARBARA		FACILITY TYPE:	850
ADDRESS:	11411 SOUTH ELEVENTH AVENUE		TELEPHONE:	(559) 582-5184
CITY:	HANFORD	STATE: CA	ZIP CODE:	93230
CAPACITY:	170	CENSUS: 111	DATE:	04/27/2023
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME BEGAN:	11:40 AM
MET WITH:	Barbara Sibrian		TIME COMPLETED:	12:35 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 04/27/2023, Licensing Program Analyst (LPA) Candis Rodriguez conducted an unannounced Case Management inspection regarding an incident that occurred at facility on 04/18/2023. LPA met with Director Barbara Sibrian, explained purpose of inspection and took a census. On 04/18/2023, facility notified Community Care Licensing (CCL) that on the same day, Child #1 was riding a bike on the bike path and collided with Child #2 who was riding a scooter in the same direction. Facility indicated Child #1 sustained an injury to the back of their head which was bleeding. Facility indicated Teacher #1, Teacher #2, and Teacher #3 were present at the time of incident and immediately assisted Child #1 and contacted parent of Child #1. Child #1 was picked up and taken to the emergency department where they received staples to close the wound. Child #1 has since returned to the facility and facility maintains documentation from emergency department on wound care. LPA observed the bike and scooter that were in use during the incident, and found the handlebars of both equipment were properly covered with rubber, and there are no sharp or pointed parts on the equipment. LPA observed the scooter which made contact with Child #1's head to be in normal working condition and not hazardous. Facility stated due to the incident, the scooter was removed from outdoor play and placed in an area inaccessible to children in care as precaution. LPA reviewed facility documentation and observed staff attended a training the following week that includes pedestrian activities and supervision. Director stated all staff work with children on teaching safety on bike paths in the outdoor area as well. LPA interviewed Teacher #1 who stated she witnessed Child #1 and Child #2 riding in the same direction when Child #2 went to pass Child #1. Child #1 was leaning to the side and the center of the scooter hit Child #1 in the back of the head. (Continued on LIC 809-C)

SUPERVISOR'S NAME: Susie Fanning	TELEPHONE: (559) 341-4117
LICENSING EVALUATOR NAME: Candis Rodriguez	TELEPHONE: (559) 341-4117
LICENSING EVALUATOR SIGNATURE:	DATE: 04/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2023

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: PRESTON J. GREEN, SR., LEARNING CENTER	FACILITY NUMBER: 163801067
	VISIT DATE: 04/27/2023

NARRATIVE

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At the time of the incident, there were 22 children outside and three staff present. Facility was within ratio and meeting supervision requirements.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies are cited. Exit interview conducted with Director. This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.

SUPERVISOR'S NAME: Susie Fanning	TELEPHONE: (559) 341-4117
LICENSING EVALUATOR NAME: Candis Rodriguez	TELEPHONE: (559) 341-4117
LICENSING EVALUATOR SIGNATURE:	DATE: 04/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2023

LIC809 (FAS) - (06/04)

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