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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103808896
Report Date: 07/21/2023
Date Signed: 07/21/2023 01:24:02 PM

Document Has Been Signed on 07/21/2023 01:24 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, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:CSN FIRM PRESCHOOLFACILITY NUMBER:
103808896
ADMINISTRATOR:AVILA, CHRISTINAFACILITY TYPE:
850
ADDRESS:1940 N. FRESNO ST.TELEPHONE:
(559) 260-2250
CITY:FRESNOSTATE: CAZIP CODE:
93703
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 7DATE:
07/21/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Yesenia AmadorTIME COMPLETED:
01:30 PM
NARRATIVE
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On 07/21/2023, Licensing Program Analysts (LPAs), Anita Tristan and Erica Pacheco met with Site Supervisor, Yesenia Amador for an unannounced Case Management- Inspection. LPAs toured the facility and a census was taken and within ratio. An Unusual Incident Report was submitted to the Fresno Community Care Licensing Office (CCL) regarding an incident that occurred on 07/3/2023.

During nap time (2) children did not want to leave the “quite area” staff assigned Teacher Carrillo to stay and watch children in the while in this area. Teacher Carrillo walked away for about 2 minutes to turn on lights for other children and when she returned to the quite area both children were covered under a blanket. Teacher removed the blanket and found that child #1 had removed his pants and underwear and child #2 was licking his butt.

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, the following deficiency is being cited: (see next page, 809 D)

***Continued on 809-C***

SUPERVISORS NAME: Cynthia Brannon
LICENSING EVALUATOR NAME: Anita Tristan
LICENSING EVALUATOR SIGNATURE: DATE: 07/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/21/2023
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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Document Has Been Signed on 07/21/2023 01:24 PM - It Cannot Be Edited


Created By: Anita Tristan On 07/21/2023 at 12:47 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: CSN FIRM PRESCHOOL
FACILITY NUMBER: 103808896

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/21/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/04/2023
Section Cited
CCR
101229(a)(1)

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Responsibility for Providing Care and Supervision. The licensee shall provide care and supervision as necessary to meet the children's needs. No child(ren) shall be left without the supervision of a teacher at any time.
This requirement was not met as evidenced by:
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Per Site Supervisor, Yesenia Amador, training will be provided to staff by 8/4/2023. A copy of the training agenda and attendance sheet will be sent to the Fresno Regional office by POC due date 8/4/2023.
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LPA's obervation. Supervision of children shall include visual observation and children should not be left unattended.This is a potential personal rights, health and safety risk to children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Cynthia Brannon
LICENSING EVALUATOR NAME:Anita Tristan
LICENSING EVALUATOR SIGNATURE:
DATE: 07/21/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/21/2023


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, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: CSN FIRM PRESCHOOL
FACILITY NUMBER: 103808896
VISIT DATE: 07/21/2023
NARRATIVE
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LPAs Anita Tristan and Erica Pacheco informed Site Supervisor that this report dated 7/21/2023 document one, Type A citation which shall be posted for 30 consecutive days as there is immediate risk to the health, safety, or personal rights of children in care.

Also, LPAs Anita Tristan and Erica Pacheco informed the Site Supervisor to provide a copy of this licensing report dated 7/21/2023 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report.

A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

Exit interview conducted and report and appeal rights were reviewed and discussed with the Site Supervisor, Yesenia Amador

A notice of site visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Cynthia Brannon
LICENSING EVALUATOR NAME: Anita Tristan
LICENSING EVALUATOR SIGNATURE:

DATE: 07/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2023
LIC809 (FAS) - (06/04)
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