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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 163808397
Report Date: 03/03/2023
Date Signed: 03/03/2023 03:30:02 PM


Document Has Been Signed on 03/03/2023 03:30 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:LEMOORE GENERATION CENTERFACILITY NUMBER:
163808397
ADMINISTRATOR:ENRIQUEZ, CARLAFACILITY TYPE:
850
ADDRESS:1075 BLAKE STREETTELEPHONE:
(559) 925-1502
CITY:LEMOORESTATE: CAZIP CODE:
93245
CAPACITY:76CENSUS: 12DATE:
03/03/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Gloria VelezTIME COMPLETED:
03:45 PM
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On 03/03/2023, Licensing Program Analyst (LPA) Daniel Alvarez met with Assistant Site Supervisor Gloria Velez for an unannounced case management inspection. A complete file review was conducted prior to today's inspection. LPA toured the facility and a census was taken. The purpose of today's inspection was to address an unusual incident that occurred at the facility on 02/07/2023.

An Unusual Incident Report was submitted to the Fresno Community Care Licensing Office (CCL) regarding an incident that occurred on 02/07/2023 involving a day-care child that slipped on a toy car, which resulted in the child falling and injuring the back of her neck. Today, LPA spoke with Assistant Site Supervisor Gloria Velez regarding the incident. First aid was provided and the child's parent was notified. The child was taken to Valley Children's Hospital the same day where she was diagnosed with a neck strain/spasms.

Today, LPA observed the indoor play area where the incident took place. The play equipment observed appeared to be age appropriate. There were two teachers providing care and supervision to the children in the indoor play area when the incident occurred; therefore, adequate ratios were in place. Assistant Site Supervisor Gloria Velez reported that Child #1 had returned to care on 02/13/2023. Assistant Site Supervisor Gloria Velez stated that staff ensures that adequate care and supervision is provided to all children in care.

Based on the information obtained, LPA determined the licensee handled the incident correctly and reporting requirements were met. LPA determined that the licensee took appropriate measures to address the incident, following both internal policy and Title 22 Regulations.

Per California Code of Regulations, Title 22, Division 12, no deficiency was cited during today's inspection.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with Assistant Site Supervisor Gloria Velez .
SUPERVISOR'S NAME: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Daniel Q AlvarezTELEPHONE: 559-243-4588
LICENSING EVALUATOR SIGNATURE:
DATE: 03/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/03/2023
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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