<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 500301324
Report Date: 06/26/2019
Date Signed: 06/26/2019 02:52:51 PM



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
04/30/2019 and conducted by Evaluator Luisa Gavoutian
PUBLIC
COMPLAINT CONTROL NUMBER: 04-CC-20190430170540
FACILITY NAME:MONTE VISTA CHILDRENS CENTERFACILITY NUMBER:
500301324
ADMINISTRATOR:GONZALES, SHERRYFACILITY TYPE:
850
ADDRESS:1619 E MONTE VISTA AVENUETELEPHONE:
(209) 632-8477
CITY:TURLOCKSTATE: CAZIP CODE:
95382
CAPACITY:108CENSUS: 37DATE:
06/26/2019
UNANNOUNCEDTIME BEGAN:
01:10 PM
MET WITH:Director - Sherry GonzalesTIME COMPLETED:
03:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility staff failed to prevent spread of communicable disease.
Facility has an insect infestation.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analysts (LPAs) Luisa Gavoutian and Candis Rodriguez conducted an unannounced complaint inspection to provide findings. LPAs met with Director, Sherry Gonzales, who accompanied LPAs during tour of facility. LPAs took a census. During the course of the investigation, LPA Gavoutian interviewed witnesses, parents, reviewed sign-in/out sheets, and reviewed facility records. Investigation revealed that the facility had at least three cases of Hand Foot and Mouth Disease (HFMD) in the months of January-February 2019. Interviews with staff and witnesses and review of facility records and photographs revealed that the facility had an ant infestation in Classroom 113 on April 29, 2019. Facility had the classroom treated with ant bait by Clark Pest Control on May 1, 2019. Licensee failed to notify Community Care Licensing (CCL) of both the HFMD outbreak and the ant infestation.
Based upon observations, and information gathered through interviews and record reviews, the preponderance of evidence standard has been met, therefore the above allegations are found to be substantiated.
(Continued on next page, LIC9099-C)
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Alice JuarezTELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Luisa GavoutianTELEPHONE: (559) 341-4725
LICENSING EVALUATOR SIGNATURE:

DATE: 06/26/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2019
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 4
Control Number 04-CC-20190430170540
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: MONTE VISTA CHILDRENS CENTER
FACILITY NUMBER: 500301324
VISIT DATE: 06/26/2019
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Per California Code of Regulations, Title 22, Division 12, Chapter 1, these deficiencies are being cited on the attached LIC-9099D. Licensee was provided with a copy of Regulation 101238(a)(1) and 101212 for review.

An exit interview conducted with Director, Sherry Gonzales. A copy of this report and Appeal Rights were provided and discussed with Director.

A Notice of Site Visit Form was posted to parent's board and must remain posted for 30 days.
SUPERVISOR'S NAME: Alice JuarezTELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Luisa GavoutianTELEPHONE: (559) 341-4725
LICENSING EVALUATOR SIGNATURE:

DATE: 06/26/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2019
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 04-CC-20190430170540
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: MONTE VISTA CHILDRENS CENTER
FACILITY NUMBER: 500301324
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/26/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Deficiency Dismissed
Type B
CCR
1
2
3
4
5
6
7
1
2
3
4
5
6
7
8
9
10
11
12
13
14
8
9
10
11
12
13
14
Request Denied
Type B
07/12/2019
Section Cited
CCR
101212(d)(1)(E)
1
2
3
4
5
6
7
101212(g)(1) Upon the occurrence...a report shall be made to the Department by telephone or fax within the Department's next working day... In addition, a written report...shall be submitted to the Department within seven days following the occurrence of such event. This requirement was not met as evidenced by:
1
2
3
4
5
6
7
Licensee to review reporting requirements and to submit written statement of understanding of reporting procedures to CCL by POC date 07/12/2019.
8
9
10
11
12
13
14
Based on interviews and record review, Licensee failed to report an outbreak of HFMD in January-February 2019 to CCL and to the local health officer; Licensee failed to report an ant infestation that occurred on April 29, 2019 to CCL. This poses a potential risk to the health, safety, or personal rights of children.
8
9
10
11
12
13
14
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: Luisa GavoutianTELEPHONE: (559) 341-4725
LICENSING EVALUATOR SIGNATURE:

DATE: 09/16/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2019
LIC9099 (FAS) - (06/04)
Page: 4 of 4