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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 153808780
Report Date: 09/15/2022
Date Signed: 09/15/2022 12:19:35 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO SOUTH 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
07/25/2022 and conducted by Evaluator Jose Penate
PUBLIC
COMPLAINT CONTROL NUMBER: 57-CC-20220725105858
FACILITY NAME:CALIFORNIA IVY LEAGUE PREP ACADEMY, PS & ICFACILITY NUMBER:
153808780
ADMINISTRATOR:MILLER, AMYFACILITY TYPE:
850
ADDRESS:2301 ASHE ROADTELEPHONE:
(661) 832-8300
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93309
CAPACITY:178CENSUS: 80DATE:
09/15/2022
UNANNOUNCEDTIME BEGAN:
11:35 AM
MET WITH:Hanan Abou HarbTIME COMPLETED:
12:20 PM
ALLEGATION(S):
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Staff handled child in a rough manner
INVESTIGATION FINDINGS:
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On 09/15/2022, Licensing Program Analyst (LPA) Jose Penate conducted a complaint inspection to discuss and provide findings regarding the above allegation. LPA met with Site Supervisor, Hanan Abou Harb. The purpose of today’s visit was to close the complaint. LPA discussed the findings and took a census. During the course of the investigation, LPA interviewed staff and reviewed facility records.

Based on interviews, the allegation of Facility staff mishandled child aggressively, has been investigated. During the course of the investigation, LPA Penate conducted interviews, it was confirmed during interviews that on 7/22/2022, staff place hand/fingers on a child’s chin to make the child understand/listen what was being directed to the child. Staff did not recall if it was aggressively lifted or if she just placed her hand on the child’s chin.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Jose Penate
LICENSING EVALUATOR SIGNATURE:

DATE: 09/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2022
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 3
Control Number 57-CC-20220725105858
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: CALIFORNIA IVY LEAGUE PREP ACADEMY, PS & IC
FACILITY NUMBER: 153808780
VISIT DATE: 09/15/2022
NARRATIVE
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Based on interviews, by LPA during this investigation, the allegation of facility staff mishandled child aggressively; the preponderance of evidence standard has been met; therefore, the above allegation is found to be SUBSTANTIATED.

California Code of Regulations, Title 22, Division 12, Chapter 3, deficiencies are being cited on the attached LIC 9099-D.

An exit interview was conducted with Director, Amy Miller.

A copy of this report and appeal rights were provided to the licensee along with a Notice of Site Visit which is to be posted for 30 days.
SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Jose Penate
LICENSING EVALUATOR SIGNATURE:

DATE: 09/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 3
Control Number 57-CC-20220725105858
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: CALIFORNIA IVY LEAGUE PREP ACADEMY, PS & IC
FACILITY NUMBER: 153808780
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/15/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/17/2022
Section Cited
CCR
101223(a)(1)
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Personal Rights. Each child receiving services from a family child care shall be accorded dignity in his/her personal relationships with staff, residents and other persons. This requirement was not met as
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Director will have all employees complete training and submit completion to CCL by poc date.
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evidenced by staff interviews. On 7/22/2022, staff place hand/fingers on a child’s chin to make the child understand/listen what was being directed to the child. Although, the intent was not to humiliate the child, the dignity of the child was violated. This poses a potential health, safety or personal rights 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.
SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Jose Penate
LICENSING EVALUATOR SIGNATURE:

DATE: 09/15/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 3