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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 103808413
Report Date: 08/21/2019
Date Signed: 08/21/2019 10:37:35 AM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
07/22/2019 and conducted by Evaluator Gloria Reyes
PUBLIC
COMPLAINT CONTROL NUMBER: 04-CC-20190722142937
FACILITY NAME:APPLES OF GOLD EDUCATIONAL CENTERFACILITY NUMBER:
103808413
ADMINISTRATOR:DUGAN, JACKIEFACILITY TYPE:
850
ADDRESS:7272 W. SHAW AVENUETELEPHONE:
(559) 276-7272
CITY:FRESNOSTATE: CAZIP CODE:
93723
CAPACITY:168CENSUS: 49DATE:
08/21/2019
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Jackie DuganTIME COMPLETED:
11:00 AM
ALLEGATION(S):
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Uncleared adult working at facility.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Gloria Reyes arrived at facility to deliver findings for the above allegation. LPA met with Director, Jackie Dugan. The investigation consisted of interviews with the director, four staff, complainant, and a review of facility records.

Investigation revealed that Staff 1, is an employee of the Church and was not fingerprint cleared. Staff 1 has access to the licensed facility to make repairs when day care children are present. Staff 1, is also a grandparent who has grandchildren who attend the facility. Staff 1, will also pick up and drop off the grandchildren. Director, Jackie Dugan was informed that the licensee would be assessed a civil penalty of $100.00 for not having a church employee fingerprint cleared. Director Dugan is also informed that staff 1 is to never be left alone with day care children when conducting maintenance work on the preschool grounds. As of 08/01/19, Staff 1 was associated to the facility and is fingerprint cleared. Therefore, the preponderance of evidence standard has been met, and the above allegation is found to be Substantiated. (see next page)
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Alice JuarezTELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Gloria ReyesTELEPHONE: (559) 341-4471
LICENSING EVALUATOR SIGNATURE:

DATE: 08/21/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/21/2019
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 04-CC-20190722142937
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: APPLES OF GOLD EDUCATIONAL CENTER
FACILITY NUMBER: 103808413
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/21/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type B
08/21/2019
Section Cited
CCR
101170(e)(1)
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Criminal Record Clearance. All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility: Obtain a California clearance or a criminal record exemption as required by the Department. This requirement was not met
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Licensee had staff 1 fingerprinted and was cleared on 08/01/19. Licensee was provided a copy of the regulations cited today. Licensee was assessed a civil penalty $100.00. Licensee agrees to have church employees’ fingerprint cleared, when the employees will be present at the licensed facility.

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as evidenced by: Based on records reviewed and interview. Staff 1 is an employee of the Church and was not fingerprint cleared. This poses a potential risk to the health, safety, or personal rights of children.
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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: Alice JuarezTELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Gloria ReyesTELEPHONE: (559) 341-4471
LICENSING EVALUATOR SIGNATURE:

DATE: 08/21/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/21/2019
LIC9099 (FAS) - (06/04)
Page: 3 of 3
Control Number 04-CC-20190722142937
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: APPLES OF GOLD EDUCATIONAL CENTER
FACILITY NUMBER: 103808413
VISIT DATE: 08/21/2019
NARRATIVE
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Per California Code of Regulations, Title 22, Division 12, Chapter 1, a deficiency is cited on the attached LIC 9099D.

An exit interview conducted with Director, Jackie Dugan. A copy of this report and appeal rights are provided. A Notice of Site Form is posted to parent’s board and must remain posted for 30 days.
SUPERVISOR'S NAME: Alice JuarezTELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Gloria ReyesTELEPHONE: (559) 341-4471
LICENSING EVALUATOR SIGNATURE:

DATE: 08/21/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/21/2019
LIC9099 (FAS) - (06/04)
Page: 2 of 3