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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 243801263
Report Date: 06/10/2019
Date Signed: 06/10/2019 02:28:25 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:HILMAR CHRISTIAN CHILDREN'S CENTERFACILITY NUMBER:
243801263
ADMINISTRATOR:OLIVEIRA, LESLIEFACILITY TYPE:
840
ADDRESS:20037 W. AMERICAN AVENUETELEPHONE:
(209) 668-1156
CITY:HILMARSTATE: CAZIP CODE:
95324
CAPACITY:70CENSUS: 16DATE:
06/10/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Leslie OliveiraTIME COMPLETED:
01:30 PM
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LPA Claudia Henley conducted a case management visit. I was met by Director Oliveira. LPA received an incident report which occurred on 5/14/19 at 4:10 p.m. Interviewed with the staff who witnessed the incident.

Staff stated that Child #1 was hanging on the monkey bars and let go. Child #1 fell to the ground and landed on her left wrist. Child sustained a fracture to the left wrist. LPA inspected the climbing structure/monkey bar area. There appeared to be adequate amount of pea gravel under and around the monkey bar area. Staff stated that when children are outside playing on the structure, that staff are positioned on all three sides of the structure.

BASED UPON INFORMATION THAT WAS OBTAINED FROM THE FACILITY STAFF, IT IS DETERMINED THAT THERE WERE NO VIOLATION OF CCL REGULATIONS. NO FURTHER ACTION IS REQUIRED AT THIS TIME.

Site Visit Notice posted. Exit interview was conducted.
SUPERVISOR'S NAME: Alice JuarezTELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Claudia HenleyTELEPHONE: (559) 341-5776
LICENSING EVALUATOR SIGNATURE:

DATE: 06/10/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2019
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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