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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543801008
Report Date: 10/08/2019
Date Signed: 10/08/2019 08:18:39 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:LONDON CHILD DEVELOPMENT CENTERFACILITY NUMBER:
543801008
ADMINISTRATOR:WALKER, SYLVIAFACILITY TYPE:
850
ADDRESS:5772 AVENUE 378TELEPHONE:
(559) 595-0317
CITY:DINUBASTATE: CAZIP CODE:
93618
CAPACITY:70CENSUS: 52DATE:
10/08/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:40 PM
MET WITH:Sylvia WalkerTIME COMPLETED:
01:45 PM
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Licensing Program Analyst (LPA) Diana Martinez conducted an unannounced case management inspection to follow up on an unusual incident that occurred at the facility on 9/11/19. The incident was called in on 9/11/19 and the Unusual Incident Report (LIC 624) was received by Fresno Community Care Licensing on 9/20/19. LPA met with Site Supervisor Sylvia Walker.

The incident occurred in toddler classroom #3 when Child #1 lost his balance as he tripped on the carpet over his own feet. Child fell and hit his forehead on the side of a shelf and sustained a 1/2 inch cut to his forehead. Staff #1 indicated that child was not running and the area was clear of any objects. First aide was applied and parent was contacted. Child was taken to ER for treatment and required stitches. Child returned to facility the following day as he obtained a clearance from doctor and is doing well. Teacher-child ratio was in compliance. LPA observed the area where incident occurred and did not observe any tripping hazards. This was an isolated incident and staff took appropriate measures to address the child’s injury following agency policies and procedures.

Per Title 22, Division 12, Chapter 3 of the California Code of Regulations, no deficiency is being cited.

Exit interview conducted with Site Supervisor Sylvia Walker and a copy of this report was provided and discussed. A Notice of Site Visit Form (LIC 9213) was posted on parent's board and must remain posted for 30 days.
SUPERVISOR'S NAME: Michael DuarteTELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Diana D MartinezTELEPHONE: (559) 341-4670
LICENSING EVALUATOR SIGNATURE:

DATE: 10/08/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2019
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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