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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103808916
Report Date: 02/26/2024
Date Signed: 02/26/2024 04:36:16 PM

Document Has Been Signed on 02/26/2024 04:36 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:EDUCARE EARLY STARS PRESCHOOLFACILITY NUMBER:
103808916
ADMINISTRATOR:MAI KUE CHANGFACILITY TYPE:
850
ADDRESS:5202 N. BLYTHETELEPHONE:
(559) 271-7827
CITY:FRESNOSTATE: CAZIP CODE:
93722
CAPACITY: 96TOTAL ENROLLED CHILDREN: 96CENSUS: 34DATE:
02/26/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Mai Kue Chang-Site SupervisorTIME COMPLETED:
02:45 PM
NARRATIVE
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On 02/26/2024, Licensing Program Analyst (LPA) Ka Vang and met with Site Supervisor Mai Kue Chang for an unannounced Case Management-Incident inspection. A complete file review was conducted prior to today’s inspection. LPA toured the facility and a census as taken. Two Unusual Incident Report (UIR) were submitted to the Fresno Community Care Licensing Office (CCL) regarding an incident occurred on 02/12/2024 and 02/20/2024. The first incident occurred on 02/12/2024, which a child slipped, fell forward and hit his/her left side forehead on a play structure. The second incident occurred on 02/15/2024, which a child reported his/her injury to a staff member, but staff member failed to report the injury to the designated individual. The purpose of this inspection was to investigate these incidents.

Regarding the first incident, per staff interview, it was disclosed that on 02/12/2024 at 10:50 AM, a child was exploring a fire truck play structure. During the child’s exploration, the child was trying to get a hold of the above rail of the fire truck, but child lost his/her balance and slipped onto the lower bar, face forwarding. During the fall, the child hit his/her forehead on the lower bar rail. During the incident, two teachers was present with eight children. A staff member observed the child did not have cuts and or open wounds; however, a bump was observed on the child’s left forehead. First aide was applied on the child. The incident was immediately reported to designated individual. Child’s parent/authorized representative was contacted immediately, and child was picked up by the parent/authorized representative at 11:15 AM for further follow-up with child’s primary caregiver. The parent/authorized representative reported to the facility that child was doing fine. The child returned to the facility next day on 02/13/2024.

Per staff interview, the fire truck play structure was immediately removed on 02/13/2024. During the inspection, LPA observed the fire truck was permanently removed from the playground and inaccessible to the children in care.

LPA reviewed pertinent documentation at the facility. LPA verified teacher-child ratios were being followed during the time of incident. Based on the information obtained, this appears to be an isolated incident and Staff took appropriate measures to address the child's injury, following proper policies and procedures and no regulations were violated.


SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Ka Vang
LICENSING EVALUATOR SIGNATURE: DATE: 02/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/26/2024
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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Document Has Been Signed on 02/26/2024 04:36 PM - It Cannot Be Edited


Created By: Ka Vang On 02/26/2024 at 02:38 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: EDUCARE EARLY STARS PRESCHOOL
FACILITY NUMBER: 103808916

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/26/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/11/2024
Section Cited
CCR
101216(k)

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Personnel Requirements: (k) The licensee or designated individual shall instruct all personnel to report observations or evidence of violations of any of the personal rights specified in Section 101223.
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Per Site Supervisor, she will work with the licensee to conduct a required reporting training to all staff members. Site Sueprvisor agrees to submit proof of training materials, confirmation of attendees, and date of training to CCL-Fresno by 03/11/2024.
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Based on observation, the licensee did not comply with the section cited above. During the interview, it was disclosed that a staff member observed a child who was crying, upset and child disclosed that child bump child’s head. The incident was not reported to the designated individuals. It was discovered that child sustained another injury result from the fall that child bumped child’s head. This poses a potential health, safety, or personal rights risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Juvenal Moctezuma
LICENSING EVALUATOR NAME:Ka Vang
LICENSING EVALUATOR SIGNATURE:
DATE: 02/26/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/26/2024


LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: EDUCARE EARLY STARS PRESCHOOL
FACILITY NUMBER: 103808916
VISIT DATE: 02/26/2024
NARRATIVE
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Regarding the second incident occurred on 02/15/2024, per staff interviews, it was disclosed that a staff member observed a child who was sitting on the bench crying and upset. The staff asked the child as to why the child was crying and the child disclosed that child bump his/her head. The incident was not reported to the designated individuals. At a later time, it was discovered that the child sustained another injury result from the fall that child bumped his/her head.

LPA reviewed pertinent documentation at the facility. LPA verified teacher-child ratios were being followed during the time of incident. Based on the information obtained, the incident was not reported to the designated individuals which the staff did not followed proper policies and procedures.


Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, a deficiency has been cited during today’s inspection. (See page LIC809-D for additional information).



Site Supervisor was provided a copy of appeal rights. A notice of site visit (LIC 9213) was given and must remain posted for 30 days. This report shall be made available to the public upon request. Exit interview conducted and report was reviewed with Site Supervisor.
SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Ka Vang
LICENSING EVALUATOR SIGNATURE:

DATE: 02/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2024
LIC809 (FAS) - (06/04)
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