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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 243801977
Report Date: 02/17/2022
Date Signed: 02/17/2022 01:33:26 PM


Document Has Been Signed on 02/17/2022 01:33 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
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710



FACILITY NAME:FRANK SPARKES PRESCHOOLFACILITY NUMBER:
243801977
ADMINISTRATOR:VANG, KAFACILITY TYPE:
850
ADDRESS:7265 W. ALMOND AVENUETELEPHONE:
(209) 357-6180
CITY:WINTONSTATE: CAZIP CODE:
95388
CAPACITY:24CENSUS: 10DATE:
02/17/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Ka Vang - PrincipalTIME COMPLETED:
01:45 PM
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On 2/17/22 Licensing Program Analyst (LPA), Joseph Pacheco arrived at the facility to conduct an unannounced Case Management Inspection. LPA met with Principal, Ka Vang to discuss an Unusual Incident that was reported to Community Care Licensing on 10/14/21. On that date the facility reported that on 10/13/21 Child #1 was climbing on a ladder on the outdoor play structure when they were bumped by other children causing them to fall off the ladder on to the cushioning below and bump their head on the structure. During today's inspection LPA interviewed Staff #1. Staff did not observe any visible injuries and applied ice to the wound. Child #1's authorized representative did not seek any additional medical treatment for Child #1. LPA inspected the area of the play structure where the incident occurred and did not observe any safety hazards or areas of concern. LPA discussed supervision at the time of the incident and it was determined that appropriate supervision was in place. The child involved in the incident was not in attendance 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.

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

Exit interview conducted and report was reviewed with Principal, Ka Vang.

This report shall be made available to the public upon request. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Joseph PachecoTELEPHONE: (559) 341-4457
LICENSING EVALUATOR SIGNATURE:
DATE: 02/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/17/2022
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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