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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543801694
Report Date: 05/18/2021
Date Signed: 05/18/2021 12:45:16 PM

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:FAMILY F.O.C.U.S.FACILITY NUMBER:
543801694
ADMINISTRATOR:TANNER, PRUDY JFACILITY TYPE:
830
ADDRESS:1504 S. KESSINGTELEPHONE:
(559) 784-2214
CITY:PORTERVILLESTATE: CAZIP CODE:
93257
CAPACITY:45CENSUS: 9DATE:
05/18/2021
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Twila Silva, Site SupervisorTIME COMPLETED:
12:45 PM
NARRATIVE
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On 05/18/2021 a case management inspection was conducted today by Licensing Program Analyst, Pete Espinoza (LPA). LPA met with, Twila Silva, Site Supervisor, to discuss an incidents that occurred on or about the month of October, 2020. LPA toured facility inside and outside. Census was taken.
Complaint investigation indicated an incident in which a child was found alone outside of the classroom. The complaint investigation revealed staff observed child in the off-limits area by the laundry shed, crouching down by the dryer vent and when child saw her, he ran towards the parking lot. It is not known how long child was alone in the off-limits area. Upon return to the classroom, staff noticed back gate of classroom patio was left unlocked.

California Code of Regulations, Title 22, Division 12, Chapter (1/3), are being cited on the attached LIC 9099D.
Today, Licensee is being issued a civil penalty in the amount of $500, per Health and Safety Code (H&S) 1548(c)(3) .

An exit interview was conducted with Twila Silva, 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.

Notes:
* Any Licensing reports indicating a Type A deficiency shall be posted immediately and for the next 30 days and copies provided of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months 1596.8595(c). Health & Safety Section 1596.859(a) shall be cited and a civil penalty of $100.00 for failure to provide copies to parents/guardians of children in care and newly enrolled children, and for failure to maintain written verification of receipt of licensing reports indicating a Type A violation (LIC 9224).

LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS.
SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Peter EspinozaTELEPHONE: 661-644-8231
LICENSING EVALUATOR SIGNATURE:

DATE: 05/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2021
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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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: FAMILY F.O.C.U.S.
FACILITY NUMBER: 543801694
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/18/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/28/2021
Section Cited

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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... Supervision shall include visual observation. This requirement is not met as evidenced by interviews with witnesses, conducted during recent complaint investigation.
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Interviews indicated staff found the child alone and unsupervised in an off-limits area for an undetermined amount of time. This poses an immediate risk to the health, safety or personal rights of children in care.
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A civil penalty of $500 was assessed and shall be paid upon receipt of the bill.

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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: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Peter EspinozaTELEPHONE: 661-644-8231
LICENSING EVALUATOR SIGNATURE:
DATE: 05/18/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/18/2021
LIC809 (FAS) - (06/04)
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