500301324-11-8-2021-04-CC-LGAN-C8L25H-20211108160533

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 500301324
Report Date: 11/08/2021
Date Signed: 11/08/2021 04:05:41 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:	MONTE VISTA CHILDRENS CENTER		FACILITY NUMBER:	500301324
ADMINISTRATOR:	GONZALES, SHERRY		FACILITY TYPE:	850
ADDRESS:	1619 E MONTE VISTA AVENUE		TELEPHONE:	(209) 632-8477
CITY:	TURLOCK	STATE: CA	ZIP CODE:	95382
CAPACITY:	108	CENSUS: 51	DATE:	11/08/2021
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME BEGAN:	09:50 AM
MET WITH:	Director - Sherry Gonzales		TIME COMPLETED:	04:15 PM

NARRATIVE

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On 11/08/2021, Licensing Program Analyst (LPA) Luisa Gavoutian conducted an unannounced Case Management inspection. LPA met with Director Sherry Gonzales, toured the facility, and took a census. The purpose of today’s inspection was to discuss an incident that was reported to Community Care Licensing (CCL) on 10/29/2021, where Child 1 suffered a broken collar bone after falling while playing outside.

LPA spoke to Director regarding the incident. Staff 1, who was present during the incident, is no longer employed at the facility. On 10/28/2021, at approximately 3:00 p.m., Staff 1 and 12 children was outside on the playground. Director stated that Child 1 was playing with other children in the grass area and Staff 1 was stationed between the play structure and the grass area. Child 1 approached Staff 1 and informed Staff 1 that Child 1 fell down and hurt their arm. Staff 1 did not witness the incident. Staff 1 administered first aid to Child 1. Staff 1 informed Staff 2 about Child 1’s fall during pick-up time. Staff 2 notified Child 1’s parent during pick-up. On 10/29/2021, Child 1 was taken to receive medical treatment and x-rays revealed that Child 1 had sustained a broken collar bone. Child 1 received appropriate medical care and returned to the facility on 11/02/2021.

Following the incident, Director counseled Staff 1 on following proper incident reporting protocols by completing accident reports, notifying the Director, and informing parents immediately to determine whether or not to seek medical treatment. Staff 1 is no longer employed at the facility.

(Continued on LIC 809-C)

SUPERVISOR'S NAME: Alice Juarez	TELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Luisa Gavoutian	TELEPHONE: (559) 341-4725
LICENSING EVALUATOR SIGNATURE:	DATE: 11/08/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2021

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: MONTE VISTA CHILDRENS CENTER	FACILITY NUMBER: 500301324
	VISIT DATE: 11/08/2021

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LPA and Director discussed the importance of providing care and supervision to children, including visual observation, at all times, both indoors and outdoors. LPA advised thoroughly training new and existing staff on the topic of care and supervision to prevent future incidents from occurring and to ensure that if an incident were to occur, a staff member would be witness to it. LPA provided Director with a list of informative videos on various licensing requirements that are available on the Department's website, which includes a video on "Supervising Children in Child Care Centers."

Per Chapter 1, Division 12, Title 22 of the California Code of Regulations, the following deficiency is found: (see LIC809-D).

Exit interview conducted and report was reviewed with Director Sherry Gonzales.

A notice of site visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Alice Juarez	TELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Luisa Gavoutian	TELEPHONE: (559) 341-4725
LICENSING EVALUATOR SIGNATURE:	DATE: 11/08/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2021

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: MONTE VISTA CHILDRENS CENTER	FACILITY NUMBER: 500301324
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 11/08/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 12/08/2021 Section Cited	1 2 3 4 5 6 7	(a) The licensee shall provide care and supervision as necessary to meet the children's needs. (1) No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation. This requirement was not met as
	8 9 10 11 12 13 14	evidenced by: Based on interview, Staff 1 failed to provide visual observation, as Staff 1 did not witness how Child 1 sustained an injury while outside on the playground. This poses a potential risk to the health, safety, or personal rights of children.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7
	1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Alice Juarez	TELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Luisa Gavoutian	TELEPHONE: (559) 341-4725
LICENSING EVALUATOR SIGNATURE:	DATE: 11/08/2021

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2021

LIC809 (FAS) - (06/04)

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