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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 240405359
Report Date: 03/18/2021
Date Signed: 03/18/2021 11:40:36 AM

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:BEAR COUNTRY PRESCHOOL & DAY CAREFACILITY NUMBER:
240405359
ADMINISTRATOR:WOLF, REGINA R.FACILITY TYPE:
840
ADDRESS:2115 WARDROBE AVENUETELEPHONE:
(209) 722-2327
CITY:MERCEDSTATE: CAZIP CODE:
95340
CAPACITY:25CENSUS: 4DATE:
03/18/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Shania Dejarnett - Administrative AssistantTIME COMPLETED:
12:00 PM
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On 3/18/21 Licensing Program Analysts (LPAs) Joseph Pacheco and Jeovanna Yanez conducted an unannounced Case Management inspection. LPAs met with Administrative Assistant, Shania Dejarnett, toured the facility and a census was taken. An Unusual Incident Report was submitted to the Fresno Child Care Regional Office on 3/1/21. On 2/25/21 Child #1 got their foot stuck in a domed shaped climbing play structure while trying to climb down. The play structure is located on the west side of the building. Staff #1 assisted Child #1 in getting their foot out of the structure. Child #1 stated they were OK and resumed play with no further issue. Later that day, the facility was contacted by Child #1's Authorized Representative and informed that Child #1 was experiencing soreness and had some bruising. Child #1 returned to care on 3/1/21. LPA's inspected the area where the Unusual Incident occurred. Staff were interviewed. Child #1 was not present during today's inspection.

This appears to be an isolated incident and staff took appropriate measures to address the child's injury, following appropriate policies, regulations and reporting requirements.

No deficiency cited during today's inspection.
SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Joseph PachecoTELEPHONE: (559) 341-4457
LICENSING EVALUATOR SIGNATURE:

DATE: 03/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/18/2021
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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