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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 153909095
Report Date: 04/20/2023
Date Signed: 04/20/2023 02:03:14 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
02/16/2023 and conducted by Evaluator Norma Lomeli
PUBLIC
COMPLAINT CONTROL NUMBER: 57-CC-20230216135840
FACILITY NAME:HERNANDEZ, NOEMI FAMILY CHILD CAREFACILITY NUMBER:
153909095
ADMINISTRATOR:HERNANDEZ, NOEMIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 348-2357
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93306
CAPACITY:14CENSUS: 5DATE:
04/20/2023
UNANNOUNCEDTIME BEGAN:
01:00 AM
MET WITH:Noemi HernandezTIME COMPLETED:
02:15 PM
ALLEGATION(S):
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Care provider did not provide adequate supervision to day care children.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Norma Lomeli arrived at facility to close complaint for the above allegation. Met with Licensee, Noemi Hernandez who accompanied LPA during tour of facility both inside and outside and census taken. LPA observed licensee's assistant caring for five day care children while playing in the backyard. During the investigation, witnesses revealed that licensee did not provide adequate supervision to children resulting a child sustaining marks on the neck.

Based upon observations, and information gathered through interviews, 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, this deficiency is being cited on the attached LIC9099-D.
(Continued on LIC9099-C):
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Duane MatsubaraTELEPHONE: (559) 650-7855
LICENSING EVALUATOR NAME: Norma LomeliTELEPHONE: (559) 331-0781
LICENSING EVALUATOR SIGNATURE:

DATE: 04/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2023
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 4
Control Number 57-CC-20230216135840
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: HERNANDEZ, NOEMI FAMILY CHILD CARE
FACILITY NUMBER: 153909095
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/20/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/05/2023
Section Cited
CCR
102417(a)
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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. When circumstances require the licensee to be temporarily absent from the home, the licensee shall arrange for a substitute adult to care for and supervise the children during his/her absence. Temporary absences shall not
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Licensee agrees to provide Fresno CCL with a written plan of supervision for the day care children, to ensure they are supervised at all times. Licensee will provide the plan to LPA Lomeli on or before 5/5/23.
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exceed 20 percent of the
hours that the facility is providing care per day. During the investigation witnesses
revealed that licensee did not provide adequate supervision to children resulting a child sustaining marks on the neck. This is a potential risk to the health, safety, or personal rights of 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 MatsubaraTELEPHONE: (559) 650-7855
LICENSING EVALUATOR NAME: Norma LomeliTELEPHONE: (559) 331-0781
LICENSING EVALUATOR SIGNATURE:

DATE: 04/20/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 4
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
02/16/2023 and conducted by Evaluator Norma Lomeli
PUBLIC
COMPLAINT CONTROL NUMBER: 57-CC-20230216135840

FACILITY NAME:HERNANDEZ, NOEMI FAMILY CHILD CAREFACILITY NUMBER:
153909095
ADMINISTRATOR:HERNANDEZ, NOEMIFACILITY TYPE:
810
ADDRESS:3509 JADE AVETELEPHONE:
(661) 348-2357
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93306
CAPACITY:14CENSUS: 5DATE:
04/20/2023
ANNOUNCEDTIME BEGAN:
01:00 AM
MET WITH:Noemi HernandezTIME COMPLETED:
02:15 PM
ALLEGATION(S):
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Care provider lied to a parent about their communication with the day care children at school regarding an incident that happened in the day care home.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Norma Lomeli arrived at facility to close complaint for the above allegation. Met with Licensee, Noemi Hernandez who accompanied LPA during tour of facility both inside and outside and census taken. LPA observed licensee's assistant caring for five day care children while playing in the backyard. During the investigation, witness revealed that licensee has good communication with parents but it was undetermined if licensee lied to parents at school regarding incident.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur; therefore the allegation is UNSUBSTANTIATED.

Per California Code of Regulations, Title 22, Division 12, Chapter 3, no deficiency is cited during today's visit.

An exit interview conducted with Licensee, Noemi Hernandez. A copy of this report and Appeal Rights were provided and discussed with Ms. Hernandez.

LPA observed director post the Notice of Site Visit Form on parent's board and understands it must remain posted for 30 days.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Duane MatsubaraTELEPHONE: (559) 650-7855
LICENSING EVALUATOR NAME: Norma LomeliTELEPHONE: (559) 331-0781
LICENSING EVALUATOR SIGNATURE:

DATE: 04/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 57-CC-20230216135840
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: HERNANDEZ, NOEMI FAMILY CHILD CARE
FACILITY NUMBER: 153909095
VISIT DATE: 04/20/2023
NARRATIVE
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An exit interview conducted with Licensee, Noemi Hernandez. A copy of this report and Appeal Rights were provided and discussed with Ms. Hernandez.

LPA observed director post the Notice of Site Visit Form on parent's board and understands it must remain posted for 30 days.
SUPERVISOR'S NAME: Duane MatsubaraTELEPHONE: (559) 650-7855
LICENSING EVALUATOR NAME: Norma LomeliTELEPHONE: (559) 331-0781
LICENSING EVALUATOR SIGNATURE:

DATE: 04/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2023
LIC9099 (FAS) - (06/04)
Page: 4 of 4