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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 103909669
Report Date: 10/26/2023
Date Signed: 10/26/2023 12:45:39 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO-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
09/29/2023 and conducted by Evaluator Yesenia Fierro
PUBLIC
COMPLAINT CONTROL NUMBER: 04-CC-20230929111233
FACILITY NAME:TAMEZ, STELLA FAMILY CHILD CAREFACILITY NUMBER:
103909669
ADMINISTRATOR:TAMEZ, STELLAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 367-1195
CITY:CLOVISSTATE: CAZIP CODE:
93619
CAPACITY:14CENSUS: 14DATE:
10/26/2023
UNANNOUNCEDTIME BEGAN:
10:06 AM
MET WITH:Stella TamezTIME COMPLETED:
11:00 AM
ALLEGATION(S):
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Licensee is not following proper safe sleep practices.
INVESTIGATION FINDINGS:
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On 10/26/2023 at 10:08 a.m., Licensing Program Analyst (LPA) Yesenia Fierro made an unannounced visit at the facility above to discuss compliant findings. LPA met with Licensee Stella Tamez and took a census. During the course of this investigation LPA reviewed pertinent records and interviewed staff and reporting staff.

Based upon records review, documentation obtained, and information received through interviews, it was determined that Licensee failed to follow safe sleep regulations and the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED.

Per California Code of Regulations, Title 22, Division 12, Chapter 3, the following deficiency is being cited (see 9099-D).

Substantiated
Estimated Days of Completion: 90
SUPERVISOR'S NAME: Rene MancinasTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Yesenia FierroTELEPHONE: (559) 794-0709
LICENSING EVALUATOR SIGNATURE:

DATE: 10/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2023
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-20230929111233
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: TAMEZ, STELLA FAMILY CHILD CARE
FACILITY NUMBER: 103909669
VISIT DATE: 10/26/2023
NARRATIVE
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An exit interview was conducted with Stella Tamez. A copy of this report and Appeal Rights were provided and discussed. A Notice of Site Visit (LIC 9213) form will be posted on the facility's parent's board and must remain posted for 30 days.
SUPERVISOR'S NAME: Rene MancinasTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Yesenia FierroTELEPHONE: (559) 794-0709
LICENSING EVALUATOR SIGNATURE:

DATE: 10/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 04-CC-20230929111233
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: TAMEZ, STELLA FAMILY CHILD CARE
FACILITY NUMBER: 103909669
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/26/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/26/2023
Section Cited
CCR
102425
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(b) Cribs or play yards shall be free from all loose articles and objects.
(j) The provider shall supervise infants while they are sleeping and adhere to the following requirements:
(2) The provider shall check and document the following:
(D) Documentation shall be maintained in the infant’s file and be available to the Department for review.

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Licensee she read safe sleep regulations
and submit a written statement on what was learned and how she plans on correcting the deficiency. Licensee will submit POC by November 10, 2023
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Documentation shall include the following:
a. Date.
b. Infant’s name.
c. Time of each 15-minute check
Based on interviews and record reviews, Licensee failed to follow safe sleep regulation by having loose articles and objects and no having complete documentation in infant files. This is a potential risk of personal rights, health and safety 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: Rene MancinasTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Yesenia FierroTELEPHONE: (559) 794-0709
LICENSING EVALUATOR SIGNATURE:

DATE: 10/26/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3