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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543801151
Report Date: 01/21/2020
Date Signed: 01/22/2020 11:41:56 AM

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:SNOWDEN CHILD DEVELOPMENT CENTERFACILITY NUMBER:
543801151
ADMINISTRATOR:MARTIN, JOSEFAFACILITY TYPE:
850
ADDRESS:281 S. FARMERSVILLE BLVD.TELEPHONE:
(559) 747-6221
CITY:FARMERSVILLESTATE: CAZIP CODE:
93223
CAPACITY:24CENSUS: 17DATE:
01/21/2020
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Josefa MartinTIME COMPLETED:
02:00 PM
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On this date, Licensing Program Analyst (LPA) Kathy Pacheco conducted an unannounced case management inspection. LPA met with Administrator, Josefa Martin, to discuss an incident that was reported on 12/12/19. LPA took a census, interviewed staff, obtained copies of documentation, and observed area in which the incident occurred.

On 12/12/19, the facility reported the mother (see Confidential Names form (LIC 811) dated 1/21/2020) of child #1 (see LIC 811) called them and said child #1 told her that Teacher #1 (see LIC 811) had hurt his arm, took a pillow away from him, and hurt his nose. Besides reporting the information to Community Care Licensing, Tulare County Office of Education - Early Childhood Education Program, conducted interviews and took staff statements regarding the information.

On 12/11/19, Teacher #1 completed a Tulare County Office of Education children's accident/illness report form. The report indicated during free flow time, child #1 was running in the classroom and jumped on the pillows, diving head first. There were toys under the pillows and child #1 hit his nose on the toys. Later, during group time, child #1 said his nose hurt and he asked for an ice pack. Staff checked child #1 and found no marks or bleeding. Child #1 was given an ice pack and was comforted as he sat in a chair during group time.

Interviews of witnesses confirmed child #1 had been running and jumping in the classroom on 12/11/19. It was also confirmed through witness interviews that Teacher #1 had picked up child #1 and carried him to his cot for quiet time. Witness interviews indicated they did not see Teacher #1 pick up child #1 in a harmful way, by pulling on him or picking him up by the arms, nor did witnesses recall Teacher #1 taking a pillow away from child #1.

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SUPERVISOR'S NAME: Michael DuarteTELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Kathy PachecoTELEPHONE: (559) 341-5116
LICENSING EVALUATOR SIGNATURE:

DATE: 01/21/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2020
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: SNOWDEN CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 543801151
VISIT DATE: 01/21/2020
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Based on the information obtained, LPA determined Licensee handled the incident correctly and reporting requirements were met. After interviewing staff and children and reviewing facility records, LPA determined Licensee took appropriate measures to address child #1's injury.

Per California Code of Regulations Title 22, Division 12, no deficiency cited during today's inspection.

LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS
SUPERVISOR'S NAME: Michael DuarteTELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Kathy PachecoTELEPHONE: (559) 341-5116
LICENSING EVALUATOR SIGNATURE:

DATE: 01/21/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2020
LIC809 (FAS) - (06/04)
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