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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 503608903
Report Date: 02/04/2020
Date Signed: 02/04/2020 03:06:24 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:KEYES HEAD STARTFACILITY NUMBER:
503608903
ADMINISTRATOR:MCCORMICK, BRANDYFACILITY TYPE:
850
ADDRESS:4621 NUNES ROADTELEPHONE:
(209) 656-2388
CITY:TURLOCKSTATE: CAZIP CODE:
95382
CAPACITY:40CENSUS: 34DATE:
02/04/2020
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Director - Brandy McCormickTIME COMPLETED:
03:20 PM
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On February 4, 2020, Licensing Program Analyst (LPA) Luisa Gavoutian conducted a Case Management inspection. LPA met with Director Brandy McCormick, toured the facility, and took a census. The purpose of today's inspection was to follow-up on an incident report that was submitted to Community Care Licensing (CCL) on January 14, 2020.

During today's inspection, LPA interviewed Teacher Mandisa Aldama, who had witnessed the incident. Teacher Aldama stated that on January 13, 2020, Child 1 was running near the big play structure outside and was going to run up the yellow steps of the play structure when Child 1 tripped and hit the top of Child 1's head on one of the steps, sustaining a cut on the top left of Child 1's head. Teacher Aldama stated the child did not cry, but there was blood. Teacher Aldama stated she cleaned the cut and administered first aid and an ice pack. Child 1's authorized representative was contacted in the meanwhile. Child 1 was taken to urgent care where a glue was applied to seal the wound. Teacher Aldama stated Child 1 returned to care the next day.

Director stated that teachers are always zoned in the outdoor playground. This facility maintains a teacher-child ratio of 1 staff supervising no more than 10 children. Staff continue to monitor children closely while children are outside in the play area and near the play structures.

This appears to be an isolated incident and facility staff followed appropriate regulations and procedures while maintaining proper care and supervision.

No deficiencies were cited during today's inspection.
LIC 9213 posted on parent's board.
SUPERVISOR'S NAME: Alice JuarezTELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Luisa GavoutianTELEPHONE: (559) 341-4725
LICENSING EVALUATOR SIGNATURE:

DATE: 02/04/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2020
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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