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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543810170
Report Date: 09/30/2022
Date Signed: 09/30/2022 10:33:17 AM

Document Has Been Signed on 09/30/2022 10:33 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:SEQUOIA PRESCHOOLFACILITY NUMBER:
543810170
ADMINISTRATOR:AMY SULLIVANFACILITY TYPE:
850
ADDRESS:1040 N WOODLAND STTELEPHONE:
(559) 730-7564
CITY:VISALIASTATE: CAZIP CODE:
93291
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 15DATE:
09/30/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Leticia TrevinoTIME COMPLETED:
10:45 AM
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On September 30, 2022 Licensing Program Analyst (LPA), Kari McWilliams, conducted an unannounced case management inspection. LPA met with Director, Leticia Trevino and toured the facility inside and out and took a census. The purpose of today's inspection was to follow up on an incident that was reported the Department on September 21, 2022 when child #1 fell down a slide and broke their collar bone.
LPA interviewed staff #1 that was present and observed the outside play area where the child fell; staff #1 walked LPA through the incident. There was 17 children present with three staff; staff #1 was right next to child when they started to "topple" on the side away from staff and staff was able to prevent child from falling over the slide edge. As staff prevented the fall over, child was still unstable and continued to go down the slide and when child landed on the ground she landed on her left shoulder. LPA observed that there was appropriate amount of cushioning under the slide and that the play structure was designed for ages 2-5 years.
Staff confirmed that they didn't place an ice pack due to not wanting to move the child's arm/shoulder and continued to give "a lot of love/comfort". Parent/guardian was called immediately and child was picked up and taken to urgent care. Child returned to the center on September 26, 2022 with no medical restrictions.
Staff #1 states that she talks to all of the children about "slide safety" and tells the children not to hang off the side of the slide to tell friends "hi", and if the children do not listen then they are given a break and can try again to listen after a few minutes. Staff stated that she was doing this prior to the incident.
Due to the staff being present next to the child and was able to immediately provide measures to prevent the child going over the side and once the child received an injury when falling at the bottom of the slide staff was immediately present to address the child and provide comfort. LPA doesn't observe any negligence on the facility that could have prevented the incident.
Per California Code of Regulations Title 22, Division 12, Chapter 1, no deficiency is cited today. Notice of Site Inspection to be posted for 30 days.
SUPERVISORS NAME: Luisa Gavoutian
LICENSING EVALUATOR NAME: Kari McWilliams
LICENSING EVALUATOR SIGNATURE: DATE: 09/30/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/30/2022
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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