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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 243801076
Report Date: 10/02/2023
Date Signed: 10/02/2023 12:54:20 PM


Document Has Been Signed on 10/02/2023 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
FRESNO-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710



FACILITY NAME:CHENOWETH PRESCHOOLFACILITY NUMBER:
243801076
ADMINISTRATOR:GUTIERREZ, EDITHFACILITY TYPE:
850
ADDRESS:1730 E. BROOKDALE AVENUETELEPHONE:
(209) 385-6772
CITY:MERCEDSTATE: CAZIP CODE:
95340
CAPACITY:24CENSUS: 14DATE:
10/02/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
11:40 AM
MET WITH:Edith GutierrezTIME COMPLETED:
01:00 PM
NARRATIVE
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On 10/2/23, Licensing Program Analyst (LPA) Priscilla Zamudio conducted an unannounced case management inspection. LPA met with Edith Gutierrez, Site Supervisor to discuss an incident which occurred on 9/20/23 and a census was also taken. LPA interviewed staff, and observed where the incident occurred.

On 9/20/23, Child#1 was left outside in a locked, enclosed play yard for 4.5 minutes. The child was later brought inside and consoled. The Director was immediately contacted and she spoke to the child and staff. The child’s parents were also notified. The staff was given a letter of warning and will also triple count students and write daily count on white board by door. The incident was not reported to licensing until 9/26/23.

Based on information gathered and interviews conducted, per Title 22, Division 12, Chapter 1, of the California Code of Regulations, the following deficiencies are cited (see LIC 809-D).

Exit interview conducted and report was reviewed with Edith Gutierrez, Site Supervisor.

This report shall be made available to the public upon request. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISOR'S NAME: Cynthia BrannonTELEPHONE: (559) 650-7884
LICENSING EVALUATOR NAME: Priscilla ZamudioTELEPHONE: (559) 578-7350
LICENSING EVALUATOR SIGNATURE:
DATE: 10/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/02/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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Document Has Been Signed on 10/02/2023 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
FRESNO-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710


FACILITY NAME: CHENOWETH PRESCHOOL
FACILITY NUMBER: 243801076

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/02/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/02/2023
Section Cited
CCR
101212(d)(1)C

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101212(d)Upon the occurrence...of any of the events specified in (d)(1)...a report shall be made to the Department by telephone or fax within the Department's next working day...(1)Events reported shall include the following: (C) Any unusual incident or child absence that threatens the physical or emotional health or safety of any child.
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Site Supervisor stated she will review Reporting Requirements (CCR, section 101212) with staff to ensure understanding of what is required to be reported to CCL and when.
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This requirement was not met as evidenced by record review and interview with Site Supervisor. Based on observation and interview, facility did not report to CCL within the next working day. This posed a potential risk to the health, safety, and personal rights of children in care.
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Type B
10/02/2023
Section Cited
CCR101229(a)(1)

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Responsibility for Providing Care and Supervision. No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation. This requirement was not met as evidenced by information obtained during
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Procedures have been revised to ensure children are visually supervised and counted by staff and documented on a board in the class. Deficiency corrected.
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interviews. Interviews indicated that Child #1 was left unsupervised in the outdoor play area for 4.5 minutes as the class was transitioning from outside to inside. This poses 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: Cynthia BrannonTELEPHONE: (559) 650-7884
LICENSING EVALUATOR NAME: Priscilla ZamudioTELEPHONE: (559) 578-7350
LICENSING EVALUATOR SIGNATURE:
DATE: 10/02/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/02/2023
LIC809 (FAS) - (06/04)
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