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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103808814
Report Date: 11/20/2024
Date Signed: 11/20/2024 02:44:16 PM

Document Has Been Signed on 11/20/2024 02:44 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 RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:ST. AGNES CHILD DEVELOPMENT CENTERFACILITY NUMBER:
103808814
ADMINISTRATOR/
DIRECTOR:		PRICE, MARYELLENFACILITY TYPE:
850
ADDRESS:1255 E. HERNDON AVE.TELEPHONE:
(559) 450-3545
CITY:FRESNOSTATE: CAZIP CODE:
93720
CAPACITY: 143TOTAL ENROLLED CHILDREN: 143CENSUS: 87DATE:
11/20/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:00 AM
MET WITH:Director Amanda TullerTIME VISIT/
INSPECTION COMPLETED:
03:00 PM
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On 11/20/2024, Licensing Program Analyst (LPA) Aurelio Mendoza conducted an unannounced Case Management – Incident visit. LPA toured the facility, took a census, and met with Director Amanda Tuller to discuss a 10/15/2024 incident where a child sustained a left arm injury on the Pre-K playground.

Child #1 tripped while running near a blue boat, resulting in a fracture. Staff #1 and #2 provided first aid and contacted the parent, who arrived promptly around 4:30 pm and took the child to a care provider. The child returned to care on 10/17/2024 with an arm brace.

LPA interviewed staff, reviewed records, and inspected the area of the injury. The incident was determined to be isolated and not due to inadequate supervision. Staff followed all procedures and reporting requirements.

No deficiencies were cited under Title 22, Division 12, Chapter 1 of the California Code of Regulations. An exit interview was conducted with Director Amanda Tuller, and a copy of Appeals Rights was provided. This report will be available to the public upon request. A notice of site visit was posted and must remain for 30 days.

SUPERVISORS NAME: Cynthia Brannon
LICENSING EVALUATOR NAME: Aurelio Mendoza
LICENSING EVALUATOR SIGNATURE: DATE: 11/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/20/2024
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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