543806013-5-3-2023-57-CC-DMAA-CRNLKR-20230509084958

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 543806013
Report Date: 05/03/2023
Date Signed: 05/03/2023 01:47:53 PM

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
04/27/2023 and conducted by Evaluator Jose Penate

PUBLIC

COMPLAINT CONTROL NUMBER: 57-CC-20230427162544

FACILITY NAME:	MENDOZA'S DAY CARE		FACILITY NUMBER:	543806013
ADMINISTRATOR:	MENDOZA, SOCORRO		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(661) 725-0445
CITY:	RICHGROVE	STATE: CA	ZIP CODE:	93261
CAPACITY:	14	CENSUS: 5	DATE:	05/03/2023
		UNANNOUNCED	TIME BEGAN:	12:15 PM
MET WITH:	Socorro Mendoza		TIME COMPLETED:	02:05 PM

ALLEGATION(S):

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Licensee did not provide a safe and comfortable environment

INVESTIGATION FINDINGS:

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On 05/03/2023, An unannounced complaint inspection was conducted today by Licensing Program Analyst (LPA), Jose Penate. LPA met with Licensee, Socorro Mendoza. Licensee is Spanish speaking. The purpose of the visit is to open and close a complaint investigation.

With the allegation of, Licensee did not provide a safe and comfortable environment, was investigated. LPA observed items in high areas that could fall over children in care, medicine cabinet that was not locked and children had access to, cluttered bookshelves, high stack of pots and pans on the kitchen counter, cleaning products, and leaf blower in the backyard.

Continued on LIC 9099-C

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Duane Matsubara	TELEPHONE: (559) 650-7855
LICENSING EVALUATOR NAME: Jose Penate	TELEPHONE: (559) 341-5860
LICENSING EVALUATOR SIGNATURE:	DATE: 05/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2023

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 57-CC-20230427162544

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: MENDOZA'S DAY CARE	FACILITY NUMBER: 543806013
	VISIT DATE: 05/03/2023

NARRATIVE

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This agency has investigated the complaint with the allegation of, Licensee did not provide a safe and comfortable environment, and based on LPA observations the preponderance of evidence standard has been met; therefore, the above allegation is found to be SUBSTANTIATED.

Per California Code of Regulations, Title 22, Division 12, deficiency cited (see LIC 9099-D).

An exit interview was conducted with Licensee, Socorro Mendoza.

A printed copy of this report as well as appeal rights were provided.

A Notice of Site Visit Form was posted on parent's board and must remain posted for 30 days.

SUPERVISOR'S NAME: Duane Matsubara	TELEPHONE: (559) 650-7855
LICENSING EVALUATOR NAME: Jose Penate	TELEPHONE: (559) 341-5860
LICENSING EVALUATOR SIGNATURE:	DATE: 05/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2023

LIC9099 (FAS) - (06/04)

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Control Number 57-CC-20230427162544

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: MENDOZA'S DAY CARE	FACILITY NUMBER: 543806013
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/03/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 05/17/2023 Section Cited CCR 102423(a)(2)	1 2 3 4 5 6 7	(a)Each child receiving services from a family child care home shall have certain rights that shall not be waived or abridged by the licensee regardless of consent or authorization from the child's authorized representative. These	1 2 3 4 5 6 7	Licensee will remove all items from areas listed on LIC 9099 and also declutter the main residence where children pass through to utilize the restroom.
	8 9 10 11 12 13 14	rights include, but are not limited to, the following: (2) To receive safe, healthful, and comfortable accommodations, furnishings, and equipment. Based on LPA observtions of items listed on LIC 9099. This poses a potential health, safety or personal rights risk to children in care.	8 9 10 11 12 13 14
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	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: Duane Matsubara	TELEPHONE: (559) 650-7855
LICENSING EVALUATOR NAME: Jose Penate	TELEPHONE: (559) 341-5860
LICENSING EVALUATOR SIGNATURE:	DATE: 05/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2023

LIC9099 (FAS) - (06/04)

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