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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 500312532
Report Date: 03/11/2024
Date Signed: 03/11/2024 01:35:17 PM

Document Has Been Signed on 03/11/2024 01:35 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
FRESNO CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:YCCD MJC EARLY CARE & EDUCATION LABORATORYFACILITY NUMBER:
500312532
ADMINISTRATOR:FORD, SARAHFACILITY TYPE:
850
ADDRESS:2201 BLUE GUMTELEPHONE:
(209) 575-6343
CITY:MODESTOSTATE: CAZIP CODE:
95358
CAPACITY: 56TOTAL ENROLLED CHILDREN: 56CENSUS: 27DATE:
03/11/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Sarah FordTIME COMPLETED:
02:00 PM
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On 03/11/2024, a Case Management Inspection was conducted by Licensing Program Analyst (LPA) Valerie Mireles. LPA met with Director Sarah Ford. A complete file review was conducted prior to visit. LPA toured facility inside and outside. A census was taken and there was a total of 27 children in care, divided into three classrooms. The purpose of today's inspection was to address an unusual incident that took place at the facility on 02/05/2024.

An Unusual Incident Report was submitted to the Fresno Community Care Licensing (CCL) Office regarding an incident that occurred, on 02/05/2024, involving a daycare child that fell while standing near a table resulting in the child sustaining bruising to the right side of the eye. On 03/11/2024, LPA spoke with Staff #1, who reportedly witnessed the incident as it occurred and was in proximity of the child when the incident occurred. According to the staff, the child was waiting to be served lunch and stood-up, lost balance and child landed the right side of their face on Staff #1’s boot. Child initially cried, was comforted, and given an ice pack. Per Staff #1, Staff #2 and Staff #3, no visible bruising or opened wound was present; however ,Several hours later, Staff #1 observed light bruising/ redness at the right side of the child’s face. During pick up, child’s parent was notified, provided with incident report and Signs to Watch -Head Injury Form. Per Director, child was taken to their doctor and saw a physician the following date of the incident and was cleared to return to school, which the child did.

On 03/11/2024, LPA observed the classroom and table where the incident took place. The table was in good condition with no visible defects. At the time of the incident there were two teachers present and approximately five children in Classroom #A, where the incident occurred; therefore, adequate supervision was in place.

Continued to LIC809-C.

SUPERVISORS NAME: Cynthia Brannon
LICENSING EVALUATOR NAME: Valerie Mireles
LICENSING EVALUATOR SIGNATURE: DATE: 03/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/11/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: YCCD MJC EARLY CARE & EDUCATION LABORATORY
FACILITY NUMBER: 500312532
VISIT DATE: 03/11/2024
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Based on the information obtained, LPA determined staff handled the incident correctly and reporting requirements were met. After interviewing staff and reviewing facility records, LPA determined facility staff took appropriate measures to address the child’s injury, following proper policies and procedures and no regulations were violated. Per Director, she stated that she will take further measures by having a staff notify her immediately should an incident take place.

Per the California Code of Regulations, Title 22, Division 12, Chapter 1, no deficiency was cited during today’s inspection. Exit interview conducted with the Director Sarah Ford.

SUPERVISORS NAME: Cynthia Brannon
LICENSING EVALUATOR NAME: Valerie Mireles
LICENSING EVALUATOR SIGNATURE:

DATE: 03/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2024
LIC809 (FAS) - (06/04)
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