<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153801756
Report Date: 02/01/2023
Date Signed: 02/06/2023 09:17:04 AM

Document Has Been Signed on 02/06/2023 09:17 AM - 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 SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:MCKINLEY ELEMENTARY SCHOOLFACILITY NUMBER:
153801756
ADMINISTRATOR:KELLI MICHAUDFACILITY TYPE:
850
ADDRESS:601 4TH STREETTELEPHONE:
(661) 631-4936
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93304
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 10DATE:
02/01/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Mayra GutierrezTIME COMPLETED:
01:15 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 2/1/2023, Licensing Program Analyst (LPA) Theresa Marquez conducted a Case Management inspection and met with teachers, Mayra Gutierrez and Maribel Bautista. LPA toured the classroom and a census was taken. An Unusual Incident Report was submitted to the Fresno South Community Care Licensing Office (CCL) regarding an incident that occurred on 12/13/2022, where during outside playtime, a daycare child was getting in line to return inside the classroom on the walkway ramp at the entrance of the classroom. The child ran out of line towards the playground down the concrete ramp, tripped and shattered her elbow. The purpose of this inspection was to investigate this incident.

LPA Marquez spoke to Teacher #1 who directly witnessed the child fall. Teacher #2 was also present outside as both teachers were supervising 12 children in the play yard area. Teacher #1 stated after the fall she asked the child if she was OK and the child responded yes. Upon entering the classroom, the child complained of pain in her arm and began to cry. First aid was administered and the child's mother was notified to pick her up. The child was taken to the hospital and surgery was performed on the child's arm on 12/14/2022.

LPA observed the area where the child tripped and noticed a section of the concrete is raised and there are cracks at the end of the ramp. LPA also observed various cracks throughout the blacktop play area which could also pose as tripping hazards. Although staff could not confirm whether or not the child tripped on the raised and cracked concrete, the concrete at the end of the ramp must be repaired to avoid children from tripping and sustaining injuries in the future.
Per Chapter 1, Division 12, Title 22 of California Code of Regulations the following deficiencies were cited today: please see page LIC809-D on next page.

Exit interview was conducted with Mayra Gutierrez. LPA provided Gutierrez with a copy of the Facility Evaluation Report (LIC 809), the Appeal Rights, and the Notice of Site Visit form (LIC 9213). The LIC 9213 is required to be posted for 30 days.
SUPERVISORS NAME: Luisa Gavoutian
LICENSING EVALUATOR NAME: Theresa Marquez
LICENSING EVALUATOR SIGNATURE: DATE: 02/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/01/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
Document Has Been Signed on 02/06/2023 09:17 AM - It Cannot Be Edited


Created By: Theresa Marquez On 02/01/2023 at 12:18 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: MCKINLEY ELEMENTARY SCHOOL
FACILITY NUMBER: 153801756

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/01/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/01/2023
Section Cited
CCR
101238.2(d)(2)

1
2
3
4
5
6
7
OUTDOOR ACTIVITY SPACE - The surface of the outdoor activity space shall be maintained: In a safe condition for the activities planned. Free of hazards including, but not limited to, holes, broken glass and other debris, and dry grasses that pose a fire hazard.
1
2
3
4
5
6
7
Teacher Gutierrez stated she will discuss with her Director requesting repairs of the raised area and cracks on the concrete of the end of the ramp outside the preschool classroom and the cracks on the blacktop area.
Director and/or teacher will notify
8
9
10
11
12
13
14
This requirement was not met as evidenced by observations: LPA observed a section of the concrete walkway ramp is raised and there are cracks at the end of the ramp where a child tripped and sustained an injury. There are also cracks throughout the blacktop area which could pose as tripping hazards. This poses a potential risk to the health, safety or personal rights of children in care.
8
9
10
11
12
13
14
LPA Marquez in writing when repairs are completed. Repairs are to be completed by 3/1/2023.

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
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:Luisa Gavoutian
LICENSING EVALUATOR NAME:Theresa Marquez
LICENSING EVALUATOR SIGNATURE:
DATE: 02/01/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/01/2023


LIC809 (FAS) - (06/04)
Page: 2 of 2