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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153911033
Report Date: 03/22/2023
Date Signed: 03/22/2023 10:53:45 AM

Document Has Been Signed on 03/22/2023 10:53 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:GIBBONS, SARA FAMILY CHILD CAREFACILITY NUMBER:
153911033
ADMINISTRATOR:GIBBONS, SARAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 369-6585
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93301
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 6DATE:
03/22/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Sara GibbonsTIME COMPLETED:
11:00 AM
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 03/22/2023, Licensing Program Analyst (LPA) Nancy Her conducted an unannounced case management inspection at the facility. LPA met with Licensee, Sara Gibbons, to discuss an incident which occurred on 03/13/2023. A complete file review was conducted prior to visit. LPA toured the facility inside and outside. LPA took a census and interviewed Licensee.

On 03/13/2023 daycare child began to have a medical emergency. Licensee immediately attended to the child and contacted parents and 911. The child was taken to the hospital by paramedics. The child was treated, released and returned to the care without restrictions.

Based on the information obtained, this appears to be an isolated incident and Licensee took appropriate measures to address the child's emergency, following proper policies and procedures and no regulations were violated. Licensee reported incident to Fresno Community Care Licensing on 03/14/2023.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies are cited.
Exit interview conducted and report was reviewed with the facility representative Sara Gibbons.

A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Nancy Her
LICENSING EVALUATOR SIGNATURE: DATE: 03/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/22/2023
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 1