Incident investigation·January 8, 2026

On 01/08/2026, Licensing Program Analyst (LPA), Christopher Burnias met with Site Supervisor, Shoua Moua for an unannounced Case Management incident inspection. LPA toured the facility, and a census was taken. The purpose of today's inspection was to address three unusual incidents that were reported to the Fresno Community Care Licensing (CCL) office. LPA interviewed Site Supervisor, along with Staff 1 (S1), who were present during an Unusual Incident that occurred at the facility. Information obtained from interviews indicate that on 11/07/25 at or around 9:30 AM Child 1 (C1) and Child 2 (C2) were playing inside Classroom 2 when C1 walked over to C2 and took a toy C2 was playing with. According to staff, C2 tried to grab the toy back from C1 and was unable to. C2 then bit C1 on the left forearm breaking skin resulting in slight bleeding. Site Supervisor stated that S1 cleaned and treated C1’s wound and parent was notified. Parent took C1 to be medically examined. Medical staff did not identify major injury however, C1 received updated immunizations at the time of visit. Site Supervisor informed LPA that at the time of the incident, they along with S1 were supervising 11 children. Site Supervisor informed LPA that their facility uses videos along with books to teach children not to bite others. According to staff, the facility uses videos and books to talk to children about certain behaviors. Staff will also talk with parents to develop a plan to address certain behaviors. LPA also interviewed S1, Staff 2 (S2), and Staff 3 (S3) regarding a second Unusual Incident involving C1 at the facility. Information obtained from interviews indicate that on 12/11/25 at or around 9:30 AM during the transition from outdoor play to indoors, C1 ran away from the group towards the playground equipment. While running, C1, tripped on the woodchips and hit their head on the tube slide. S2 went to C1 to assess the injury and observed a visible bump on C1’s head and did not observe any open wound or bleeding. C1 was offered a cold compress, but did not want it. Parent was notified of the incident and parent picked up C1 and took them home. Site Supervisor informed LPA that the next day, parent notified them that C1 woke up with a headache and vomited multiple times. Parent took C1 to Valley Children’s Hospital in Madera, CA and C1 received a CT scan and was medically examined. Medical staff did not identify any major injury from CT results, however child was provided anti-nausea medication and sent home. Site Supervisor informed LPA that at the time of the incident, S1, S2 and Staff 3 (S3) were supervising 14 children. LPA inspected playground area where C1 fell and did not observe any tripping hazards present. LPA also interviewed S1, S2, and S3 regarding a third Unusual Incident which involved C2. Information obtained from interviews indicate that on 01/07/26 at or around 8:50 AM during outdoor play time, C2 and Child 3 (C3) were riding bikes when C3 bumped their bike into C2 causing C2 to fall off their bike and onto the ground. S3 stated that when C2 fell, they assessed C2 and observed that the left side of their lip was bleeding. S2 provided first aid by cleaning C2’s mouth and provided an ice pack to C2. Parent was notified to inform them of the incident. Site Supervisor informed LPA that at the time of the incident, S1, S2 and Staff 3 (S3) were supervising 13 children. After interviewing staff members about all three unusual incidents, LPA has determined that the facility was within ratio requirements. LPA also observed locations where staff and children were positioned for all three unusual incidents and LPA has determined that adequate supervision was provided despite the individual incidents occurring. Staff took appropriate measures to assess each incident, and no regulations were violated. Per Title 22, Division 12, Chapter 1 of the California Code of Regulations, no deficiencies are cited during today's visit. An exit interview was conducted with Site Supervisor, Shoua Moua and appeal rights were provided. This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and is required to be posted for 30 days.