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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 543801039
Report Date: 11/02/2022
Date Signed: 11/02/2022 10:19:54 AM

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
09/29/2022 and conducted by Evaluator Peter Espinoza
COMPLAINT CONTROL NUMBER: 57-CC-20220929145427
FACILITY NAME:BURTON CHILD DEVELOPMENT CENTERFACILITY NUMBER:
543801039
ADMINISTRATOR:HERNANDEZ, ERNESTINEFACILITY TYPE:
850
ADDRESS:2375 W. MORTONTELEPHONE:
(559) 784-4852
CITY:PORTERVILLESTATE: CAZIP CODE:
93257
CAPACITY:19CENSUS: 0DATE:
11/02/2022
UNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Maria Trevino, Site SupervisorTIME COMPLETED:
10:30 AM
ALLEGATION(S):
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Personal Rights
INVESTIGATION FINDINGS:
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The facility is closed and LPA met with staff at another facility to report complaint findings. On 11/02/2022, Licensing Program Analyst (LPA) Pete Espinoza met with Maria Trevino, Site Supervisor to complete the investigation into the above allegations.

Based upon observations and information gathered through interviews, the Licensing agency has determined the preponderance of evidence standards has been met, therefore, the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 12, Chapter (1/3), are being cited on the attached LIC 9099D.
An exit interview was conducted with Maria Trevino, Site Supervisor, a plan of correction was discussed, and appeal rights were explained. A printed copy of this report as well as a printed copy of the appeal rights was provided at the conclusion of the visit.

LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Duane MatsubaraTELEPHONE: (559) 650-7855
LICENSING EVALUATOR NAME: Peter EspinozaTELEPHONE: (661) 644-8231
LICENSING EVALUATOR SIGNATURE:

DATE: 11/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2022
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 2
Control Number 57-CC-20220929145427
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: BURTON CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 543801039
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/02/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/30/2022
Section Cited
CCR
101223(a)(2)
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Personal Rights - The licensee shall ensure that each child is accorded the following personal rights: To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs. This requirement is not met as evidenced by interviews and records review conducted during the complaint investigation.
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Licensee will provide training for staff associated to facility regarding methods in providing adequate supervision and response in situations which may result in injury to child in Preschool.
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Staff failed to provide adequate supervision resulting more than one injury to child enrolled in preschool. This poses a potential risk to the health, safety or personal rights of children in care.
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Licensee will send copy of agenda and sign-in sheet to Fresno Regional Office by 11/30/2022.
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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: Peter EspinozaTELEPHONE: (661) 644-8231
LICENSING EVALUATOR SIGNATURE:

DATE: 11/02/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2