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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543909145
Report Date: 11/03/2023
Date Signed: 11/03/2023 12:41:36 PM

Document Has Been Signed on 11/03/2023 12:41 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 SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:BERMUDEZ, MARIA FAMILY CHILD CAREFACILITY NUMBER:
543909145
ADMINISTRATOR:BERMUDEZ, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 781-4214
CITY:PORTERVILLESTATE: CAZIP CODE:
93257
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 5DATE:
11/03/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Maria BermudezTIME COMPLETED:
12:55 PM
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On 11/3/2023, Licensing Program Analyst (LPA) Ruby Ocegueda conducted an unannounced case management – unusual incident inspection. LPA met with licensee Maria Bermudez, toured the facility, and took a census. The purpose of today's inspection was to follow-up on an unusual incident that was reported to Community Care Licensing (CCL) on 10/27/2023. The Incident reported was regarding a child who fell and hit his/her head causing a cut to the head that required medical treatment.

During today's inspection, LPA interviewed licensee regarding the unusual incident, reviewed child #1’s file,and inspected facility. On 10/27/2023, Licensee reported to the Department that on that day, child #1 was running and turned into the sink area of the daycare room. Licensee heard a “thump” and child #1 begin to cry. Licensee was nearby in the same room but child was out of sight due to the lay out of the daycare room. Licensee suspects that child hit his/her head on a cabinet or the sink bottom cabinet area. Licensee stated that she applied first aid and called the parent. Child was taken to seek medical care that same day and was treated with stiches to close the small cut on child #1’s head. Child returned to care without further incident or additional care directives on 10/28/2023.

Licensee stated that since the incident she has discussed with parents the types of shoes children should wear at day care. Licensee indicated that she has encouraged parents wear more sturdy shoes instead of “crock style shoes” as she notices that children tend to fall more in these shoes. Licensee continues to remind children to walk while inside. LPA did not observe any tripping hazards in the area and confirmed that the day care room floors were clean and orderly. Report continued 809-C
SUPERVISORS NAME: Susie Fanning
LICENSING EVALUATOR NAME: Ruby Ocegueda
LICENSING EVALUATOR SIGNATURE: DATE: 11/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/03/2023
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 SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: BERMUDEZ, MARIA FAMILY CHILD CARE
FACILITY NUMBER: 543909145
VISIT DATE: 11/03/2023
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Facility met all reporting requirements as specified in Title 22 Regulation 101212 - Reporting Requirements. The incident is an isolated incident and not a result of lack of care and supervision.

No deficiencies were cited in the areas observed today. This report is to be made available to the public upon request.

LIC 9213 Notice of Site Visit to be posted for 30 days.
SUPERVISORS NAME: Susie Fanning
LICENSING EVALUATOR NAME: Ruby Ocegueda
LICENSING EVALUATOR SIGNATURE:

DATE: 11/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/03/2023
LIC809 (FAS) - (06/04)
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