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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 163801632
Report Date: 06/03/2022
Date Signed: 06/03/2022 12:54:33 PM


Document Has Been Signed on 06/03/2022 12:54 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
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710



FACILITY NAME:HOME GARDEN LEARNING CENTERFACILITY NUMBER:
163801632
ADMINISTRATOR:SIBRIAN, BARBARAFACILITY TYPE:
850
ADDRESS:9726 HOME AVENUETELEPHONE:
(559) 582-7075
CITY:HANFORDSTATE: CAZIP CODE:
93230
CAPACITY:40CENSUS: 22DATE:
06/03/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Emma Collins and Latonya IyamuTIME COMPLETED:
01:10 PM
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On 06/03/2022, Licensing Program Analyst (LPA) Candis Rodriguez conducted an unannounced Case Management inspection at facility. LPA met with Teacher/Supervisor Emma Collins and Family Services Worker Latonya Iyamu. LPA explained the purpose inspection, toured facility, and took a census.

On 05/27/2022, facility reported to Community Care Licensing that on 05/25/2022, Child #1 was mistakenly sent home with the incorrect person, Adult #1, who was actually there to pick up Child #2. Adult #1 was the friend of Parent #1 (parent of Child #2). Facility reported Teacher #1 released Child #1 to Adult #1. Parent #2 and Parent #3 (parents of Child #1) came to facility to pick up Child #1, and became aware Child #1 was not there. Teacher #2 stated she thought the grandmother picked up Child #1. Family Services Worker contacted grandmother of Child #1 and it was confirmed Child #1 was not picked up by grandmother. As facility was trying to figure out who Child #1 left with, Parent #1 (parent of Child #2) called facility to let them know she received Child #1 by mistake. Parent #1 immediately brought Child #1 back to facility who was reunited with their parents, Parent #2 and Parent #3. Parent #1 picked up her child, Child #2.

LPA interviewed Teacher #2 and Family Services Worker. It was revealed through interview this incident took place sometime between 2:00pm and 3:00pm. LPA reviewed children's sign in/out sheets from 05/25/2022. LPA observed Child #1 was signed out at 2:30 by Parent #3, and Child #2 was signed out at 2:30 by Parent #1. Teacher #2 stated parents often do not put the actual time of pick up, but their regular time, which explains why the times written by parents are not accurate. Teacher #2 stated Child #1 was gone from the facility for approximately 5 minutes. Teacher #2 stated she was assisting Child #2 in the restroom at the time Teacher #1 released Child #1 to the incorrect person and did not witness who picked up Child #1. Family Services Worker stated she is not sure how long Child #1 was away from facility, but approximated 15 minutes.

(Continued on LIC 809-C)
SUPERVISOR'S NAME: Michael DuarteTELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Candis RodriguezTELEPHONE: (559) 341-4117
LICENSING EVALUATOR SIGNATURE:
DATE: 06/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/03/2022
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 4


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: HOME GARDEN LEARNING CENTER
FACILITY NUMBER: 163801632
VISIT DATE: 06/03/2022
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LPA reviewed Child #2's file. Adult #1, who picked up Child #1 by mistake, is listed as an authorized pick up person for Child #2.

LPA interviewed Parent #1 and Parent #2. Interview with Parent #1 revealed that she added Adult #1 to authorized pick up list for Child #2 the day prior, 05/24/2022. Interviews indicate Child #1 was away from facility for up to 20 minutes, but can not be confirmed exactly how long based on interviews and records review.

LPA spoke with Site Supervisor Shoua Moua by telephone while at facility. SS stated she was not present at the time of incident. SS stated she was informed Teacher #1 was terminated due to this incident.

Based on record review and interviews, it was determined facility did not ensure Adult #1 showed identification or signed out for either Child #1 or Child #2, which resulted in absence of supervision of Child #1.

Facility was given notice of informal conference scheduled with Community Care Licensing to discuss concerns.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following deficiency is being cited: (see LIC 809-D). Licensee was provided a copy of their appeal rights.

LPA informed Teacher/Supervisor that this report dated 06/03/2022 documents one Type A citation which shall be posted for 30 consecutive days as there is an immediate risk to the health, safety, or personal rights of children in care. Immediate Civil Penalty was assessed for the day 05/25/2022 in the amount of $500.

Also, LPA informed Teacher/Supervisor to provide a copy of this licensing report dated 06/03/2022 that documents any Type A citation 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 Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with Teacher/Supervisor.

SUPERVISOR'S NAME: Michael DuarteTELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Candis RodriguezTELEPHONE: (559) 341-4117
LICENSING EVALUATOR SIGNATURE:

DATE: 06/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/03/2022
LIC809 (FAS) - (06/04)
Page: 2 of 4
Document Has Been Signed on 06/03/2022 12:54 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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


FACILITY NAME: HOME GARDEN LEARNING CENTER
FACILITY NUMBER: 163801632

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/03/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/03/2022
Section Cited

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CCR 101229(a) The licensee shall provide care and supervision as necessary...(1) No child(ren) shall be left without the supervision of a teacher at any time...Supervision shall include visual observation. This requirement was not met as evidenced by:
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Based on record review and interview, facility did not ensure Child #1 was supervised by facility when releasing Child #1 to an incorrect individual, who then left facility premises. This poses an immediate risk to the health, safety, and personal rights of children in care.
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Facility agreed to send the log and outline to CCL by 06/30/2022. Facility was given notice of informal conference scheduled with CCL to discuss concerns. Immediate Civil Penalty was assessed for the day 05/25/2022 in the amount of $500.

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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: Michael DuarteTELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Candis RodriguezTELEPHONE: (559) 341-4117
LICENSING EVALUATOR SIGNATURE:
DATE: 06/03/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/03/2022
LIC809 (FAS) - (06/04)
Page: 3 of 4


Document Has Been Signed on 06/03/2022 12:54 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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


FACILITY NAME: HOME GARDEN LEARNING CENTER
FACILITY NUMBER: 163801632

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/03/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/15/2022
Section Cited

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CCR 101229.1(b) The person who brings the child to, and removes the child from, the center shall sign the child in/out. This requirement was not met as evidenced by:
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Based on interview and record review, facility did not ensure Adult #1 (authorized representative for Child #2) signed out for Child #2. This poses a potential risk to the health, safety, and personal rights of children in care.
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Facility agreed to send the log and outline to CCL by 06/30/2022. Facility was given notice of informal conference scheduled with CCL to discuss concerns.

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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: Michael DuarteTELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Candis RodriguezTELEPHONE: (559) 341-4117
LICENSING EVALUATOR SIGNATURE:
DATE: 06/03/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/03/2022
LIC809 (FAS) - (06/04)
Page: 4 of 4