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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364844696
Report Date: 09/06/2024
Date Signed: 09/06/2024 10:57:27 AM

Document Has Been Signed on 09/06/2024 10:57 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
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:VOA SOUTHWEST FONTANA EARLY LEARNING CENTERFACILITY NUMBER:
364844696
ADMINISTRATOR/
DIRECTOR:		GURTIS, ISABELFACILITY TYPE:
850
ADDRESS:14750 LIVE OAK AVENUETELEPHONE:
(909) 743-6565
CITY:FONTANASTATE: CAZIP CODE:
92337
CAPACITY: 225TOTAL ENROLLED CHILDREN: 225CENSUS: 76DATE:
09/06/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:30 AM
MET WITH:Isabel GurtisTIME VISIT/
INSPECTION COMPLETED:
11:15 AM
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On the date and time listed above, a case management visit was being conducted in response to the receipt of an unusual incident report (UIR) from the facility. The UIR was received by the licensing agency on 08/06/24. The incident report indicated that there was a child playing with classmates, running around the playground. While running, the child fell on the grass. While falling, the child extended their arms out in front of them and landed on top of their arms/hands. The child let one of their teachers know that they fell and their hand hurt. The staff applied ice, called the authorized representative and let the authorized representative know that the child's hand was hurting. The child seemed fine for the remainder of the day, until they woke up from their nap and started to cry again once they saw the authorized representative, who was there for a regular pick up of their child. The authorized representative took the child to the hospital and the fall resulted in a fractured wrist. The child did return to the school in a sling the following day.

Based on information gathered, the facility acted appropriately, and no violations have been identified. The incident had been determined to be an accident.

An exit interview was conducted and a copy of this report, appeal rights and notice of site visit was provided to site director, Isabel Gurtis.

A Notice of Site Visit was issued and must be posted for 30 days.

SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Aman Lama
LICENSING EVALUATOR SIGNATURE: DATE: 09/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/06/2024
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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