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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 103810106
Report Date: 04/18/2024
Date Signed: 04/18/2024 04:24:05 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710
This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/29/2024 and conducted by Evaluator Anita Tristan
COMPLAINT CONTROL NUMBER: 04-CC-20240129115103
FACILITY NAME:JACK & JILL'S EARLY CHILD DEVELOPMENT CENTER, INCFACILITY NUMBER:
103810106
ADMINISTRATOR:GRAVES, EARLINE EVETTEFACILITY TYPE:
830
ADDRESS:969 S WILLOW AVETELEPHONE:
(559) 255-8817
CITY:FRESNOSTATE: CAZIP CODE:
93727
CAPACITY:16CENSUS: 9DATE:
04/18/2024
UNANNOUNCEDTIME BEGAN:
03:40 PM
MET WITH:Earline GravesTIME COMPLETED:
05:02 PM
ALLEGATION(S):
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Infant ingested a button battery.
INVESTIGATION FINDINGS:
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On 04/18/2024, Licensing Program Analysts (LPAs) Anita Tristan conducted an unannounced complaint inspection to provide finding regarding the above allegations. LPA discussed and explained the allegations and findings with Director, Earline Graves. IB Investigator Jennifer Torres conducted the investigation, which included review of facility records, review of local law enforcement records, and interviews with the staff and medical staff. IB Torres also obtained documentation and medical records.

LPA Tristan observed 8 infant/toddlers in the infant room with 2 teachers and 1 toddler with 1 teacher conducting diaper change during today's inspection.

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Cynthia Brannon
LICENSING EVALUATOR NAME: Anita Tristan
LICENSING EVALUATOR SIGNATURE:

DATE: 04/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 04-CC-20240129115103
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: JACK & JILL'S EARLY CHILD DEVELOPMENT CENTER, INC
FACILITY NUMBER: 103810106
VISIT DATE: 04/18/2024
NARRATIVE
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Based on IB investigation it remains unknown to when or where child #1 ingested the battery, Due to there being no sufficient indication of when or where child #1 could have obtained/swallowed the button battery, it cannot be confirmed that it took place while she was at the daycare.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.

Per California Code of Regulations, Title 22, Division 12, Chapter 1, no deficiency is cited during today’s visit.

Exit interview conducted with the Director, Earline Graves and appeal rights were provided and discussed.

A Notice of Site Visit was provided and must be posted for 30 days.

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

DATE: 04/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2