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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 163911791
Report Date: 08/15/2024
Date Signed: 08/15/2024 10:34:29 AM

Document Has Been Signed on 08/15/2024 10:34 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 RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:ALVAREZ, MARGARITA FAMILY CHILD CAREFACILITY NUMBER:
163911791
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 2DATE:
08/15/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:15 AM
MET WITH:Margarita AlvarezTIME VISIT/
INSPECTION COMPLETED:
10:45 AM
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On 08/15/2024, Licensing Program Analysts (LPAs) Octavia Nolan and Yesenia Fierro conducted an unannounced Case Management- Incident visit regarding an unusual incident report that was submitted to the Community Care Licensing office on 07/24/2024, where a daycare child sustained an injury.

LPAs were met by licensee Margarita Alvarez. Also present was licensee's husband Daniel Gonzalez. LPAs took a census and a tour of the facility.

LPAs asked licensee and her husband a series of questions regarding the unusual incident report. Licensee states Child 1 was dropped off at approximately 7:40 AM. Child 1 fell forward while running towards the door and caught herself with her hands. Licensee and her husband were present at the time of the fall and witnessed the incident. Licensee stayed in contact with the mother throughout the day and requested that Child 1 is picked up early due to the incident. Child 1 was picked up by an authorized representative at 5:00 PM and taken to a local hospital. They were referred to Valley Children's Hospital due to an injury to the elbow.

LPA observed that the facility had appropriate supervision during the incident and the child's needs were immediately met with first aid and parental contact. LPA also observed child file of Child 1 had appropriate documentation of the incident. Licensee reported the incident within Community Care Licensing Guidelines. LPA observed the area where child fell and there are no hazards present. Licensee attempted to contact parent after incident and parent was not responsive. Parent disenrolled Child 1 on Monday, July 29th, 2024.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiency is being cited.
Notice of Site Inspection to be posted for 30 days.
SUPERVISORS NAME: Gloria Reyes
LICENSING EVALUATOR NAME: Octavia Nolan
LICENSING EVALUATOR SIGNATURE: DATE: 08/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/15/2024
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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