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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 100406467
Report Date: 05/21/2025
Date Signed: 05/21/2025 12:33:55 PM

Document Has Been Signed on 05/21/2025 12:33 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 CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:FRESNO CITY COLLEGE CHILD DEVELOPMENT CENTERFACILITY NUMBER:
100406467
ADMINISTRATOR/
DIRECTOR:		PHENGSIRI J & ANTONIO EFACILITY TYPE:
850
ADDRESS:1621 EAST UNIVERSITY AVETELEPHONE:
(559) 443-8618
CITY:FRESNOSTATE: CAZIP CODE:
93704
CAPACITY: 130TOTAL ENROLLED CHILDREN: 65CENSUS: 62DATE:
05/21/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:40 AM
MET WITH:Estefana Antonio and Jessica PhengsiriTIME VISIT/
INSPECTION COMPLETED:
12:50 PM
NARRATIVE
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On 05/20/2025, Licensing Program Analysts (LPAs) Miguel Herrera and Meche Rosales conducted an unannounced case management inspection at the facility. LPAs met with Director, Estefana Antonio and Director Jessica Phengsiri who accompanied LPAs during a tour of the facility both inside and outside. LPAs explained the purpose for the inspection. An incident was self-reported to Child Care Licensing Regional Office on 05/15/2025 by the facility, regarding inadequate supervision that resulted in inappropriate behavior by a day-care child.

Through interviews and records review, it was confirmed that there was inadequate supervision for approximately 10 to 15 minutes while child #1 and child #2 played in the outdoor area’s plastic tunnels to when the children were noticed inside the tunnels by staff. Based on interviews and records reviewed child #2 behaved inappropriately while playing in the tunnels.

Through interviews and records review, it was determined that the incident was an isolated incident. Although the facility followed appropriate reporting requirements and took appropriate measures to address the incident, the facility did not provide adequate supervision while both children played in the plastic tunnels. Constant supervision was not maintained as staff did not properly zone the tunnel area, which posed an immediate risk to children in care (see LIC 809-D Type A deficiency).

Per Directors the facility will conduct on-going staff training discussing responsibility providing care and supervision. During today’s inspection LPAs conducted observations while children played in the outside play area. LPAs discussed proper supervision and zoning in specific areas of the play yard.

Continued on 809-C.

NAME OF LICENSING PROGRAM MANAGER: Juvenal Moctezuma
NAME OF LICENSING PROGRAM ANALYST: Miguel Herrera
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/21/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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Document Has Been Signed on 05/21/2025 12:33 PM - It Cannot Be Edited


Created By: Miguel Herrera On 05/21/2025 at 11:26 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: FRESNO CITY COLLEGE CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 100406467

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/21/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/23/2025
Section Cited
CCR
101229(a)(1)

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101229 Responsibility for Providing Care and Supervision
(a) The licensee shall provide care and supervision as necessary to meet the children's needs.
(1) No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation.

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A staff meeting will be conducted covering Child Care Licensing regulation101229 Responsibility for Providing care and Supervision, and the center’s procedures on supervision zoning in classrooms and outside areas.
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This requirement is not met as evidenced by:
Based on interviews and records review, it was confirmed there was inadequate supervision.
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A sign-in sheet will be provided at the beginning of the training. Staff will print their name, date of attendance and provide signatures. Directors will submit the sign-in sheet and presentation materials to CCLD Fresno by POC deadline.

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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.
Juvenal Moctezuma
NAME OF LICENSING PROGRAM MANAGER:
Miguel Herrera
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 05/21/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/21/2025


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
FRESNO CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: FRESNO CITY COLLEGE CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 100406467
VISIT DATE: 05/21/2025
NARRATIVE
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Exit interview conducted and report was reviewed with Director, Estefana Antonio and Director, Jessica Phengsiri. Appeal rights were provided. Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, the following deficiency is being cited: (see LIC. 809-D). Upon receipt of a Type A violation, licensee shall post and provide copies 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. A copy of the Fact Sheet - Child Care Parent Notification Requirements and a copy of Acknowledgement of Receipt of Licensing Reports (LIC 9224) was given to Director, Estefana Antonio. This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.

End of Report.

NAME OF LICENSING PROGRAM MANAGER: Juvenal Moctezuma
NAME OF LICENSING PROGRAM ANALYST: Miguel Herrera
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2025
LIC809 (FAS) - (06/04)
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