503808634-6-5-2023-04-CC-CBRN-CSRTAY-20230613143420

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 503808634
Report Date: 06/05/2023
Date Signed: 06/05/2023 01:03:55 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
06/02/2023 and conducted by Evaluator Priscilla Zamudio

PUBLIC

COMPLAINT CONTROL NUMBER: 04-CC-20230602110753

FACILITY NAME:	SEQUOIA PRESCHOOL ACADEMY		FACILITY NUMBER:	503808634
ADMINISTRATOR:	GUTHMILLER, JANET		FACILITY TYPE:	850
ADDRESS:	1308 COFFEE ROAD		TELEPHONE:	(209) 526-2273
CITY:	MODESTO	STATE: CA	ZIP CODE:	95355
CAPACITY:	30	CENSUS: 19	DATE:	06/05/2023
		UNANNOUNCED	TIME BEGAN:	11:45 AM
MET WITH:	Janet Guthmilller		TIME COMPLETED:	01:30 PM

ALLEGATION(S):

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Facility is operating out of scope of license.

INVESTIGATION FINDINGS:

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On 06/5/2023, Licensing Program Analyst (LPA) Priscilla Zamudio, conducted an unannounced complaint inspection to investigate the above allegation. LPA met with Director, Janet Guthmiller. LPA took a census, discussed the allegation and reviewed documentation.

Director acknowledged that she has recently operated out of the scope of the license while caring for a child who is 7 years old, however, she has already notified the parent about disenrollment, to maintain compliance.

Based on interviews, observation and information gathered during the investigation, the preponderance of evidence standard has been met, therefore the above allegation is SUBSTANTIATED.

Per California Code of Regulations, Title 22, Division 12, Chapter 1, this deficiency is being cited on the attached LIC 9099-D.
An exit interview was conducted with Director Janet Guthmilller. A copy of this report and Appeal Rights were provided and discussed.

LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Cynthia Brannon	TELEPHONE: (559) 650-7884
LICENSING EVALUATOR NAME: Priscilla Zamudio	TELEPHONE: (559) 578-7350
LICENSING EVALUATOR SIGNATURE:	DATE: 06/05/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 04-CC-20230602110753

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: SEQUOIA PRESCHOOL ACADEMY	FACILITY NUMBER: 503808634
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/05/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 06/05/2023 Section Cited CCR 101161(a)	1 2 3 4 5 6 7	Limitations on Capacity. A licensee shall not operate a child care center beyond the conditions and limitations specified on the license, including the capacity limitation. This requirement is not met as evidenced by observation, interviews, and records reviewed conducted during today’s inspection.	1 2 3 4 5 6 7	Director informed parent of Child #1 that their child shall no longer attend this facility due to their age being over the licensing requirement. Director agreed to operate in compliance of the Title 22 Regulations at all times.
	8 9 10 11 12 13 14	It was determined that Child #1 attended the child care center at the age of 7 years old. This poses a potential risk to the health, safety, or personal rights of children in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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 Brannon	TELEPHONE: (559) 650-7884
LICENSING EVALUATOR NAME: Priscilla Zamudio	TELEPHONE: (559) 578-7350
LICENSING EVALUATOR SIGNATURE:	DATE: 06/05/2023

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2023

LIC9099 (FAS) - (06/04)

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