<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153808615
Report Date: 10/01/2021
Date Signed: 10/07/2021 02:03:45 PM

Document Has Been Signed on 10/07/2021 02:03 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
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:TIERRA SERENA CHILD DEVELOPMENT CENTERFACILITY NUMBER:
153808615
ADMINISTRATOR:MARY LOPEZFACILITY TYPE:
850
ADDRESS:17213 CENTRAL VALLEY HWYTELEPHONE:
(661) 746-0671
CITY:SHAFTERSTATE: CAZIP CODE:
93263
CAPACITY: 60TOTAL ENROLLED CHILDREN: 0CENSUS: 16DATE:
10/01/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Lorena PalomoTIME COMPLETED:
02:00 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 10/01/2021, Licensing Program Analyst (LPA) Jeovanna Yanez conducted an unannounced case management inspection. LPA toured the facility and a census was taken. LPA met with Center Director, Lorena Palomo. The purpose today's inspection was to discuss an incident that occurred on 9/21/21, in which child #1 was left unsupervised in the outdoor play area for approximately five minutes. This incident was reported to the Fresno Community Care Licensing Office on 9/21/21 by Center Director, Lorena Palomo.

During today's inspection, LPA interviewed Center Director (CD) whom was associated with the incident. Additionally, LPA conducted a telephone interview with Program Director. Information obtained revealed that while transitioning from outdoor to indoor, child #1 hid from staff #1 and remained in the outdoor play area while the rest of the classroom went indoors for snack time. CD stated she was indoors with three (3) children while staff #1 was outdoors with seven (7) children. As the children were transitioning from outdoor to indoor, CD was interacting with child #2, and staff #1 was occupied with children in the restroom helping them wash their hands and sit down to eat snack. As the children finished transitioning into the classroom, and after about five minutes, staff realized child #1 was missing. CD and staff #1 checked the classroom and restroom for child #1. CD went to check the outdoor playground area while staff #1 stayed in the classroom with the children. CD observed child #1 in the outdoor play area, sitting at the bottom of the slide crying stating, "They left me." Child #1 was brought back into the classroom and observed for any injuries. Child #1 was deemed safe by staff and child #1’s guardians were immediately contacted. Program Director, Adriana Barron was also contacted at that time.

LPA observed the outdoor playground area and observed the play area that is utilized by children to be fenced in, in a manner to prevent other individuals from accessing the playground. The gate to the playground is self-latching and locking so that only staff members with keys can lock/unlock the gate to the play area. (Continued on 809-C)

*This is an amended report.

SUPERVISORS NAME: Diana deLeon
LICENSING EVALUATOR NAME: Jeovanna Yanez
LICENSING EVALUATOR SIGNATURE: DATE: 10/01/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/01/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
Document Has Been Signed on 10/01/2021 01:48 PM - It Cannot Be Edited


Created By: Jeovanna Yanez On 10/01/2021 at 08:44 AM
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: TIERRA SERENA CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 153808615

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/01/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/01/2021
Section Cited
CCR
101229(a)(1)

1
2
3
4
5
6
7
Responsibility for Providing Care and Supervision (a) (1) No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation. This requirement was not met as evidenced by staff interviews.
1
2
3
4
5
6
7
Center director immediately made changes to the outdoor play area to remove any blind spots. Center director has also emailed LPA copies of memos regarding outside procedures, tranistioning procedures and active supervision, templates to document children's attendance, and statements of
8
9
10
11
12
13
14
Information obtained indicated that child #1 was left in the outdoor play area unsupervised for approximately 5 minutes. This poses an immediate risk to the health, safety or personal rights of children in care. A civil penalty of $500 was assessed.
8
9
10
11
12
13
14
acknowledgement from staff that have watched two videos on active supervision. Deficiency cleared during visit.

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
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:Diana deLeon
LICENSING EVALUATOR NAME:Jeovanna Yanez
LICENSING EVALUATOR SIGNATURE:
DATE: 10/01/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/01/2021


LIC809 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: TIERRA SERENA CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 153808615
VISIT DATE: 10/01/2021
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Center Director acknowledged that as a result of lack of supervision, child #1 was left in the outdoor play area unsupervised. This poses an immediate risk to the health, safety, or personal rights of children in care.

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, the following deficiency is being cited: (see next page, 809 D) Exit interview conducted with Center Director, Lorena Palomo and a copy of appeal rights was provided.



Upon receipt of a Type A violation, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. A copy of the Fact Sheet - Child Care Parent Notification Requirements and a copy of LIC 9224 was given to licensee.

This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.
SUPERVISORS NAME: Diana deLeon
LICENSING EVALUATOR NAME: Jeovanna Yanez
LICENSING EVALUATOR SIGNATURE:

DATE: 10/01/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/01/2021
LIC809 (FAS) - (06/04)
Page: 3 of 3