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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103808052
Report Date: 01/10/2024
Date Signed: 01/10/2024 02:03:04 PM

Document Has Been Signed on 01/10/2024 02:03 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:FRESNO EOC CEDARWOOD HEAD STARTFACILITY NUMBER:
103808052
ADMINISTRATOR:MARTINEZ, RACHELFACILITY TYPE:
850
ADDRESS:2063 S CEDARTELEPHONE:
(559) 263-1205
CITY:FRESNOSTATE: CAZIP CODE:
93727
CAPACITY: 45TOTAL ENROLLED CHILDREN: 45CENSUS: 26DATE:
01/10/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:20 PM
MET WITH:Shoua Yang, TeacherTIME COMPLETED:
02:20 PM
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On 1/10/24, Licensing Program Analyst (LPA) Priscilla Zamudio conducted an unannounced case management inspection. LPA met with Ms. Yang to discuss an incident which occurred on 12/14/23 and a census was also taken. LPA interviewed staff and observed where the incident occurred.

On 12/14/23, at approximately 10:30 am, during outdoor play, child #1 was playing/running with the rolling popper toy on the sidewalk. Child#1 fell and hit head on the concrete which caused a quarter sized bump on the forehead. No skin was broken but bruising was observed.

Staff reported they took child#1 inside the classroom, wiped forehead and applied ice pack. Staff contacted the mother of child#1 who picked up and took child to urgent care. Staff spoke to mother about head injury instructions and provided documentation about symptoms to know. Child #1 did not return to school as winter break started on 12/15/23-1/8/23. There was no additional information provided by parent and the child is now doing well back at school.

Based on information gathered and observations made by LPA, there were no obvious concerns or hazards found. Staff are implementing adequate care and supervision at the facility.

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, no deficiencies are cited.
Exit interview conducted and report was reviewed with, Shoua Yang, Teacher.

This report shall be made available to the public upon request. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Cynthia Brannon
LICENSING EVALUATOR NAME: Priscilla Zamudio
LICENSING EVALUATOR SIGNATURE: DATE: 01/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/10/2024
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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