<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 503600806
Report Date: 05/17/2019
Date Signed: 05/17/2019 12:09:20 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:SALIDA CHILD DEVELOPMENT CENTERFACILITY NUMBER:
503600806
ADMINISTRATOR:VANDER WEIDE, TANYAFACILITY TYPE:
850
ADDRESS:4519 FINNEY ROADTELEPHONE:
(209) 545-3728
CITY:SALIDASTATE: CAZIP CODE:
95368
CAPACITY:51CENSUS: 35DATE:
05/17/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Rose Aguilar, Program SecretaryTIME COMPLETED:
12:45 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
LPA Claudia Henley conducted a case management visit today. The purpose of today's visit was due to an incident which occurred at the facility on 4/4/19 at 9:30 a.m. on the playground. A tour of the facility and census was taken. LPA reviewed one staff file and one child's file. In addition, LPA reviewed sign in/sign out sheets for 4/4/19. According to sign in/sign out sheets, there were 49 children with nine staff out on the playground at the time of the incident.

On 4/4/19 at approximately 9:30 a.m. out on the playground an incident occurred with Staff #1 and Child #1. According to interviews which was obtained, Child #1 was running away from Staff #1 while out on the playground. Staff #1 grabbed Child #1 by the right arm, resulting in a fingernail mark/scratch which broke the skin on Child #1 arm.

The following is cited per Title 22 Regulations (see page 2). Appeal Rights left with center representative.

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

DATE: 05/17/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/17/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 2
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: SALIDA CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 503600806
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/17/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/17/2019
Section Cited
CCR
101223(a)(3)
1
2
3
4
5
6
7
101223(a)(3) Personal Rights. Each child shall be free from corporal or unusual punishment, humiliation, intimidation, ridicule, coercion, threat,
1
2
3
4
5
6
7
District conducted an "all staff" meeting on 4/11/19. In addition, a staff member from each classroom will need to supervise the children while
8
9
10
11
12
13
14
mental abuse, or other actions of a punitive nature. This requirement was not met as evidenced by: On 4/4/19 while out on the playground, Staff #1 grabbed Child #1 right arm, resulting in a fingernail mark/scratch on the child's arm.
This is a risk to children in care
8
9
10
11
12
13
14
out on the playground area. Staff #1 was terminated from employment on 4/10/19. POC cleared
1
2
3
4
5
6
7
1
2
3
4
5
6
7
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 JuarezTELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Claudia HenleyTELEPHONE: (559) 341-5776
LICENSING EVALUATOR SIGNATURE:

DATE: 05/17/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/17/2019
LIC809 (FAS) - (06/04)
Page: 2 of 2