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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 503905596
Report Date: 08/15/2023
Date Signed: 08/15/2023 01:24:47 PM

Document Has Been Signed on 08/15/2023 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:GUDINO, PATRICIA FAMILY CHILD CAREFACILITY NUMBER:
503905596
ADMINISTRATOR:GUDINO, PATRICIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 765-0246
CITY:CERESSTATE: CAZIP CODE:
95307
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 12DATE:
08/15/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Patricia GudinoTIME COMPLETED:
01:35 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 08/15/2023, Licensing Program Analysts (LPAs) Ka Vang and Pa Kou Vue conducted an unannounced case management inspection. LPAs toured the facility, and a census was taken. LPAs met with Licensee Patricia Gudino. The purpose today's inspection was to discuss an unusual incident occurred on 08/07/2023, in which child #2 was injured in the facility. Licensee failed to report the incident to the Fresno Community Care Licensing (CCL) Office.

During the case management inspection, Licensee stated that on 08/07/2023 at 4:00 PM to 4:30 PM, Licensee was in the approved kitchen and Child #2 (C2) was in the playpen in the livingroom. Child #6 (C6) was also in the livingroom which Licensee had vision of the children. As licensee was preparing food in the kitchen, Licensee observed C6 went inside the playpen and both C2 and C6 were playing in the playpen. Licensee heard C2 crying. Licensee went to the playpen and picked up C2. Licensee observed C2 did not have any bruises and/or open wounds. Licensee then comforted C2. On 08/07/2023 at 7:00 PM, C2’s mother texted Licensee and disclosed that C2 had two bite marks on her left arm.



During the case management inspection, Licensee stated that the incident of C2 with the bite marks occurred during C2 and C6 were in the playpen. Licensee stated that she did not know that she had to report to CCL-Fresno of the incident that C6 bit C2. Licensee stated that since the incident occurred on 08/07/2023, C2 has not return to the facility.

Staff and children’s file reviews were conducted. LPAs observed Assistant did not have current Immunization Record, Mandated Reporter Training, LIC 9052 Employee Rights and LIC 9108 Statement Acknowledging Req. To Report Child Abuse in file.

Per the California Code of Regulations, Title 22, Division 12, Chapter 3, the following deficiencies are being cited during today’s inspection. (See next page, LIC809-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 the Licensee.
SUPERVISORS NAME: Rene Mancinas
LICENSING EVALUATOR NAME: Ka Vang
LICENSING EVALUATOR SIGNATURE: DATE: 08/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/15/2023
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 2
Document Has Been Signed on 08/15/2023 01:24 PM - It Cannot Be Edited


Created By: Ka Vang On 08/15/2023 at 12:29 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: GUDINO, PATRICIA FAMILY CHILD CARE
FACILITY NUMBER: 503905596

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/15/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/18/2023
Section Cited
CCR
102416.1(d)

1
2
3
4
5
6
7
(d) All personnel records shall be maintained at the child care home and shall be available to the licensing agency for review.

Based on record review, the licensee did not comply with the section cited above in that Licensee did not have a file with required licensing documents for Assistant which poses a potential health, safety, or personal rights risk to persons in care.
1
2
3
4
5
6
7
Licensee agreed that she will complete Assistant's file with required licensing documents and provide proof to Licensing Program Anaylst Pa Kou Vue or CCL - Fresno by 08/22/2023.
Type B
08/18/2023
Section Cited
CCR
101212(d)(1)(E)

1
2
3
4
5
6
7
Reporting Requirements…(d) The licensee shall report to the Department as provided by Health and Safety Code Sections 1597.467(b)(1) and (2)…"A report shall be made to the department by telephone or fax during the department's normal business hours before the close of the next working day following the occurrence during the operation of family day care home of…the…events." (2) Health and Safety Code Section 1597.467(b)(2) provides: "In addition to the report required pursuant to paragraph (1), a written report shall be submitted to the department within seven days following the occurrence of any events specified in paragraph (A) Child's name, age, sex and date of admission...D) Disposition of the case."
1
2
3
4
5
6
7
Licensee agreed that she will complete online training via the CDSS Child Care Reporting Requirements. Website information and steps for accessing the videos provided. Licensee will submit Plan of Correction and acknowledgment statment to CCL-Fresno by 08/22/2023.

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:Rene Mancinas
LICENSING EVALUATOR NAME:Ka Vang
LICENSING EVALUATOR SIGNATURE:
DATE: 08/15/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/15/2023


LIC809 (FAS) - (06/04)
Page: 2 of 2