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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 240400247
Report Date: 05/14/2021
Date Signed: 05/14/2021 02:15:36 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:FRUITLAND CHRISTIAN PRESCHOOLFACILITY NUMBER:
240400247
ADMINISTRATOR:CHAMBERS, PAYIAFACILITY TYPE:
850
ADDRESS:2100 FRUITLAND AVE.TELEPHONE:
(209) 358-7981
CITY:ATWATERSTATE: CAZIP CODE:
95301
CAPACITY:62CENSUS: 32DATE:
05/14/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:10 PM
MET WITH:Payia ChambersTIME COMPLETED:
02:30 PM
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On May 14, 2021, Licensing Program Analysts (LPAs) Ginny Badhesha and Jeovanna Yanez conducted a Case Management inspection. LPA met with Director, Payia Chambers. A tour of the facility was made and a census was taken. The purpose of today's inspection was to conduct a case management visit. LPAs were following up on an unusual incident that was filed on March 15, 2021. The incident was regarding a child falling from the monkey bars causing an injury to the chin. LPAs conducted the visit to gather more information regarding the incident and after discussion with staff LPAs concluded the incident was handled correctly.

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

LIC 9213 Notice of Site Visit form is required to be posted for 30 days.
SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Gagandip BadheshaTELEPHONE: (559) 575-6900
LICENSING EVALUATOR SIGNATURE:

DATE: 05/14/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2021
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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