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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103801211
Report Date: 06/22/2023
Date Signed: 06/22/2023 11:55:39 AM

Document Has Been Signed on 06/22/2023 11:55 AM - 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:SELMA MIGRANT HEAD STARTFACILITY NUMBER:
103801211
ADMINISTRATOR:GARCIA, GILBERTFACILITY TYPE:
850
ADDRESS:12898 S. FOWLER AVENUETELEPHONE:
(559) 896-4479
CITY:SELMASTATE: CAZIP CODE:
93662
CAPACITY: 45TOTAL ENROLLED CHILDREN: 45CENSUS: 18DATE:
06/22/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Gilbert GarciaTIME COMPLETED:
12:15 PM
NARRATIVE
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On 6/22/2023, Licensing Program Analyst (LPA) Ocegueda conducted an unannounced case management inspection for the purpose of addressing an Unusual Incident that was reported to the Department on 6/12/2023. Today, LPA toured the facility and took a census.

Today, LPA Ocegueda interviewed multiple staff, collected and requested records. The incident reviewed today occurred during music time in classroom pre-k 1 where there were three staff supervising 12 children. After interviewing staff, it was determined that camera footage captured Staff #1 slap child #1 on his/her back area. Site Supervisor confirmed that he saw the footage and confirmed the incident. According to interviews, the slap was enough to produce a sound. Staff #2 observed the incident and reported the incident to Site Supervisor on the same day. Child #1 is nonverbal and could not be interviewed today. Multiple staff that were privately interviewed today reported that staff #1 has a “rough” tone when verbally reacting to the children in general. Staff #1 indicated that others have brought up the concerns of staff #1 “yelling at children” and he/she reported to LPA that he/she is trying to improve on how he/she addresses children.

In addition, multiple staff reported that staff #1 reacted with firmly tapping or nearly tapping child #2 on the fingers with a pencil staff #1 was holding to get child #2 to stop touching food during lunch time. Staff #2 and #3 were interviewed at different times in private and shared the same account of what they observed sometime during the first week of June 2023 (exact date unknown). Staff #2 and Staff #3 demonstrated the incident while holding a pen today. Staff #2 and staff #3 did not report the incident to anyone at the time but was disclosed today. Site Supervisor did not report this incident as he was not made aware of it until today. Report continued to 809-C

SUPERVISORS NAME: Susie Fanning
LICENSING EVALUATOR NAME: Ruby Ocegueda
LICENSING EVALUATOR SIGNATURE: DATE: 06/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/22/2023
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
FRESNO SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: SELMA MIGRANT HEAD START
FACILITY NUMBER: 103801211
VISIT DATE: 06/22/2023
NARRATIVE
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Today, LPA Ocegueda discussed Personal Rights Regulations with Site Supervisor Gilbert Garcia and reviewed possible training on staff reporting any concerning staff behavior to him or other superiors.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following deficiency is being cited: (see next page, 809 D) Site Supervisor was provided a copy of appeal rights.

Upon receipt of a Type A violation, licensee/site supervisor 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 LIC 9224 was given to Site Supervisor.

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.

SUPERVISORS NAME: Susie Fanning
LICENSING EVALUATOR NAME: Ruby Ocegueda
LICENSING EVALUATOR SIGNATURE:

DATE: 06/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/22/2023
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 06/22/2023 11:55 AM - It Cannot Be Edited


Created By: Ruby Ocegueda On 06/22/2023 at 11:28 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: SELMA MIGRANT HEAD START
FACILITY NUMBER: 103801211

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/22/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/23/2023
Section Cited
CCR
101223(a)(3)

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Personal Rights: To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse or other actions of a punitive nature including but not limited to: interference with functions of daily living including eating, sleeping or toileting; or withholding of shelter, clothing, medication or aids to physical functioning. This requirement was not met as evidenced by: Interviews.
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Today, Site Supervisor showed that all staff at the facility had since signed a form that reviewed Personal Rights. Site Supervisor will also be providing staff training on Personal Rights of children. An agenda with topics will be submitted to the Department by POC date 6/23/2023. The deficiency will be cleared after training is complete and agenda is signed and dated by all staff at the facility.
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Interviews confirmed that staff #2 observed staff #1 slap child #1 with an open hand. Interviews revealed video footage captured the incident. This posed an immediate risk to the health, safety and or personal rights risk to 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:Susie Fanning
LICENSING EVALUATOR NAME:Ruby Ocegueda
LICENSING EVALUATOR SIGNATURE:
DATE: 06/22/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/22/2023


LIC809 (FAS) - (06/04)
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