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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103808967
Report Date: 11/08/2023
Date Signed: 11/08/2023 04:31:21 PM

Document Has Been Signed on 11/08/2023 04:31 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:NANCY FULLER CHILDREN'S UNIVERSITY, INCFACILITY NUMBER:
103808967
ADMINISTRATOR:FULLER, NANCYFACILITY TYPE:
850
ADDRESS:7901 N CEDAR AVETELEPHONE:
(559) 447-5865
CITY:FRESNOSTATE: CAZIP CODE:
93720
CAPACITY: 80TOTAL ENROLLED CHILDREN: 80CENSUS: 45DATE:
11/08/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:20 PM
MET WITH:Director Nancy FullerTIME COMPLETED:
04:45 PM
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On 11/08/2023 an unannounced case management visit was conducted by Licensing Program Analyst (LPA) Aurelio Mendoza. LPA Mendoza met with Director Nancy Fuller, and a census was taken. The purpose of this report is to document an incident that was discussed during the unannounced case management visit.

On 10/02/2023 at approximately 10:30 am an incident occurred where child #1 was observed jumping off a foam piece (Soft Tunnel Set piece) and falling onto grass where he fell onto his right wrist. Staff #1 brought the child inside the building where Director Becky Dritz assisted child #1 and directed Staff # 2 to contact the child’s father and mother. First aid was administered. Upon establishing phone communication with father, he requested that emergency services be called so that child #1 could receive care. Father arrived at facility and waited for ambulance and left with child #1 to hospital. Child #1 was provided with a cast and returned to care on 10/05/2023. LPA Mendoza discussed supervision at the time of the incident, and it was determined that appropriate supervision was in place. Staff will continue to maintain 100% supervision while children are engaging in play. LPA Mendoza inspected the area where the incident took place and did not observe any safety hazards or areas of concerns. Additionally, LPA Mendoza confirmed that Soft Tunnel Set piece was within the recommended age limits. Facility has also taken the measure of removing the Soft Tunnel Set piece post the incident.

This appears to be an isolated incident and staff took appropriate action and measures to address the child’s injury, following appropriate policies, regulations, and reporting requirements.

Per Chapter 1, Division 12, Title 22 of the California Code of Regulations no deficiencies were observed today. An exit interview was conducted with Director Nancy Fuller and a copy of this report along with LIC 9213 Notice of Site Visit form was provided to Mrs. Fuller.

Notice of Site Visit form is required to be posted for 30 days.
SUPERVISORS NAME: Cynthia Brannon
LICENSING EVALUATOR NAME: Aurelio Mendoza
LICENSING EVALUATOR SIGNATURE: DATE: 11/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/08/2023
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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