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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543808649
Report Date: 10/23/2019
Date Signed: 10/23/2019 01:46:05 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:A PLACE TO GROW MONTESSORIFACILITY NUMBER:
543808649
ADMINISTRATOR:VEDENOFF,BLAIR/CLANCY,NINAFACILITY TYPE:
850
ADDRESS:3535 SOUTH AKERSTELEPHONE:
(559) 627-3535
CITY:VISALIASTATE: CAZIP CODE:
93277
CAPACITY:146CENSUS: 110DATE:
10/23/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Blair VedenoffTIME COMPLETED:
01:45 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
On this date, Licensing Program Analyst (LPA) Theresa Marquez conducted a Case Management inspection and met with Director Blair Vedenoff. The purpose of this inspection is to discuss an incident report received by Community Care Licensing on October 16, 2019.

The Director stated that on October 10, 2019, Child #1 was sitting on a child size chair and for no reason she fell off her chair, hitting her chin on another chair. At that moment Teacher M.Rodriquez approached Child #1 and observed that she was bleeding. First Aid was administered and parents were notified. Parents transported Child #1 to the doctor where she received 3 stiches to her chin.

At the time of the incident there were 23 children with 2 staff present. It was determined that appropriated supervision was in place. LPA inspected the Maple classroom where the incident took place and did not observed any safety hazards or areas of concern. Staff took appropriate measures to address Child #1 injury.

No deficiency cited at this inspection



SUPERVISOR'S NAME: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Theresa MarquezTELEPHONE: (559) 341-7123
LICENSING EVALUATOR SIGNATURE:

DATE: 10/23/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2019
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 1