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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543801694
Report Date: 10/10/2022
Date Signed: 10/10/2022 02:56:58 PM


Document Has Been Signed on 10/10/2022 02:56 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 SOUTH CC, 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: 14DATE:
10/10/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Twila Silva, DirectorTIME COMPLETED:
03:15 PM
NARRATIVE
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On 10/10/2022, A Case Management inspection was conducted today by Licensing Program Analyst, Pete Espinoza. LPA met with, Twila Silva, Director, to discuss incident which occurred on 09/29/2022. LPA toured facility inside and outside. Census was taken. LPA interviewed staff and observed area in which incident occurred.

Staff reported incident in which child was left in fenced area of play yard. Staff stated they were outside with 10-11 children and 5-6 staff. Staff stated when they returned inside classroom, they noticed child was missing and when they went outside, observed child with a staff person who was returning from break. Staff reported incident to Director who reported incident to Agency Administration. Director reported incident tor parent.

Teacher-Child ratio was reportedly in place when the incident took place. Based on the information obtained, the incident indicates that child was unknowingly left in play yard for less than one minute.

California Code of Regulations, Title 22, Division 12, Chapter (1/3), are being cited on the attached LIC 9099D.

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

To order forms, etc. visit our website at www.ccld.ca.gov.
SUPERVISOR'S NAME: Duane MatsubaraTELEPHONE: (559) 650-7855
LICENSING EVALUATOR NAME: Peter EspinozaTELEPHONE: (661) 644-8231
LICENSING EVALUATOR SIGNATURE:
DATE: 10/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/10/2022
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 10/10/2022 02:56 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 SOUTH CC, 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: 10/10/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/10/2022
Section Cited

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Responsibility for Providing Care and Supervision - The licensee shall provide care and supervision as necessary to meet the children's needs. This requirement is not met as evidenced by interviews with witnesses, records review conducted during today’s inspection. Staff unknowingly left child in play yard for less than one minute. This poses an 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: Duane MatsubaraTELEPHONE: (559) 650-7855
LICENSING EVALUATOR NAME: Peter EspinozaTELEPHONE: (661) 644-8231
LICENSING EVALUATOR SIGNATURE:
DATE: 10/10/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/10/2022
LIC809 (FAS) - (06/04)
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