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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153909429
Report Date: 07/13/2023
Date Signed: 07/13/2023 11:26:56 AM

Document Has Been Signed on 07/13/2023 11:26 AM - 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 SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:PIMENTEL, ANDREA FAMILY CHILD CAREFACILITY NUMBER:
153909429
ADMINISTRATOR:PIMENTEL, ANDREAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 770-6711
CITY:WASCOSTATE: CAZIP CODE:
93280
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 8DATE:
07/13/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:35 AM
MET WITH:Andrea PimentelTIME COMPLETED:
11:40 AM
NARRATIVE
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On 07/13/2023, Licensing Program Analyst (LPA) Jose Penate met with Licensee Andrea Pimentel for an unannounced Case Management Inspection. The purpose of today’s inspection was to address an unusual incident reported to Fresno Community Care Licensing office on 6/28/2023 regarding a child that was left with adequate supervision during outdoor play time, which resulted in the child leaving the premises. Today, LPA interviewed the licensee and obtained additional information regarding the occurrence.

Licensee reported that on 6/28/2023, at about 10:00 AM, 12 day-care children were present, 11 children were engaging in outdoor play at the family childcare, while she remained inside feeding an infant child. Licensee stated that she maintained supervision of children in the backyard area by visually observing them through the sliding glass door located in the dining room; however, when she went outside to physically check on the children, she noticed that Child #1 was gone. Licensee stated that her husband and son immediately began looking around the neighborhood for Child #1 while she maintained supervision of the remaining children and called law enforcement to report the occurrence and request assistance locating the child. Licensee stated that law enforcement located Child #1 and returned the child to the family childcare home at approximately 10:40AM. Licensee stated that law enforcement indicated that the child likely left the family childcare home by exiting through the side gate within the backyard. Licensee approximates that the child was missing for 10-15 minutes, but after report date she has now stated it was roughly 30-40 minutes.

During interview Licensee stated that on the date of the incident she was caring for 12 children while her assistant left for an errand. Licensee was recently approved by CCL for a Large License, and she stated that she was unaware that she had to have a qualified assistant when having more than 8 children in care. LPA discussed with licensee that due to the ratio not being met, this could have been the reason to the child fleeing the facility. Licensee understood and stated that she will follow Title 22 regulations.

Continued on LIC809-C

SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Jose Penate
LICENSING EVALUATOR SIGNATURE: DATE: 07/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/13/2023
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: PIMENTEL, ANDREA FAMILY CHILD CARE
FACILITY NUMBER: 153909429
VISIT DATE: 07/13/2023
NARRATIVE
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Licensee acknowledged that due to the absence of adequate supervision, Child #1 was able to leave the home without her knowledge.

LPA Penate informed licensee that this report dated 07/13/2023 document with two Type A citations, which shall be posted for 30 consecutive days as there was an immediate risk to the health, safety, or personal rights of children in care.

Also, LPA Penate informed licensee to provide a copy of this licensing report dated 07/13/2023 that documents two Type A citations 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 Reports (LIC 9224), or other written statement, must be placed in the child's file for verification. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following deficiency is being cited: (see next page, LIC 809 D).

Licensee was provided a copy of appeal rights. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with Licensee.

SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Jose Penate
LICENSING EVALUATOR SIGNATURE:

DATE: 07/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2023
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 07/13/2023 11:26 AM - It Cannot Be Edited


Created By: Jose Penate On 07/13/2023 at 10:38 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: PIMENTEL, ANDREA FAMILY CHILD CARE
FACILITY NUMBER: 153909429

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/13/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/31/2023
Section Cited
CCR
102417(a)

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102417(a) Operation of a Family Child Care Home. The licensee shall be present in the home and shall ensure that children in care are supervised at all times. This requirement was not met as evidenced by records review and
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Licensee stated that she is aware that children in care must be adequately monitored and supervised at all times. Licensee stated that she will submit a written plan of action, detailing the methods she will implement going forward to ensure that adequate care and supervision is provided to children at all times. This plan of correction is to be submitted to the Fresno Community Care Licensing Office by 07/31/2023.
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interview with the licensee.
Licensee reported that on 6/28/2023, Child #1 left the backyard of the family childcare home without her knowledge. Child #1 was returned to the family childcare home by a law enforcement officer roughly 30-40 minutes later (see LIC809 for further details). This poses an immediate health, safety, and/or personal rights risk to children in care. A civil penalty of $500.00 was assessed.
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Type A
07/31/2023
Section Cited
HSC102416.5(e)

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102416.5 Staffing Ratio and Capacity(e) If no assistant provider is present at a Large Family Child Care Home, then the licensee shall comply with the capacity requirements for a Small Family Child Care Home as
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Licensee stated that she would ensure to no have more than 8 children in care while being alone. She would ensure to have an assistant present when the capacity goes over 8 children in care.
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specified in subsections (b) and (c). This requirement was not met as evidenced by interview with licensee. Licensee stated that she had 12 children when the incident occured and she was unaware that an assistant had to be present when the capacity went over 8 children. This poses an immediate health, safety, and/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.
SUPERVISOR'S NAME:Duane Matsubara
LICENSING EVALUATOR NAME:Jose Penate
LICENSING EVALUATOR SIGNATURE:
DATE: 07/13/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/13/2023


LIC809 (FAS) - (06/04)
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