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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153801097
Report Date: 03/08/2022
Date Signed: 03/08/2022 01:11:27 PM

Document Has Been Signed on 03/08/2022 01:11 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
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:CHILDTIME CHILDREN'S CENTERFACILITY NUMBER:
153801097
ADMINISTRATOR:MORENO, MARY ANNFACILITY TYPE:
830
ADDRESS:9903 CAMINO MEDIATELEPHONE:
(661) 665-7790
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93311
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 10DATE:
03/08/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:05 PM
MET WITH:Mary Ann MorenoTIME COMPLETED:
01:30 PM
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On 3/8/22 Licensing Program Analyst (LPA) Caroline Harris conducted an unannounced case management inspection. LPA met with Director, Mary Ann Moreno to discuss the incident which occurred on 2/24/22. A census was taken and the LPA interviewed staff and observed the area in which the incident occurred.

On 2/24/22, at approximately 9:30 am a child was playing with a medium sized truck in the middle of the toddler classroom and tried to move it with his/her foot, causing the truck to roll away, making the child fall on his/her left side. The child suffered a fractured ankle. Both staff members in the classroom were close by and one observed the incident, but stated that it happened so fast that she could not stop it from happening. The child’s parent was notified and the licensee reported the incident to Community Care Licensing.

Based on the information obtained, LPA determined Licensee handled the incident correctly and the reporting requirements were met. After interviewing staff and reviewing the Unusual Incident Report, the LPA determined the Licensee took appropriate measures to address the child's injury, following proper policies and procedures and no regulations were violated.

Per California Code of Regulations, Title 22, Chapter 1, Division 12, no deficiency was cited during today's visit. An exit interview was conducted with Director, Mary Ann Moreno and a copy of this report along with a LIC 9213 Notice of Site Visit form was provided to Mrs. Moreno.

LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS. To order forms, etc. visit our website at www.ccld.ca.gov.
SUPERVISORS NAME: Alice Juarez
LICENSING EVALUATOR NAME: Caroline Harris
LICENSING EVALUATOR SIGNATURE: DATE: 03/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/08/2022
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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