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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 103810257
Report Date: 06/26/2025
Date Signed: 06/26/2025 02:43:25 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO CC RO, 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
03/17/2025 and conducted by Evaluator Miguel Herrera
PUBLIC
COMPLAINT CONTROL NUMBER: 04-CC-20250317082050
FACILITY NAME:INCLUSION LEARNING CENTER-CLOVIS HILLS CHURCHFACILITY NUMBER:
103810257
ADMINISTRATOR:MONICA PETERSONFACILITY TYPE:
860
ADDRESS:10590 N WILLOW AVETELEPHONE:
(209) 329-6792
CITY:CLOVISSTATE: CAZIP CODE:
93619
CAPACITY:15CENSUS: 3DATE:
06/26/2025
UNANNOUNCEDTIME BEGAN:
12:50 PM
MET WITH:Elizabed GonzalezTIME COMPLETED:
03:00 PM
ALLEGATION(S):
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Child sustained unexplained injury while in care.
INVESTIGATION FINDINGS:
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On June 26, 2025, Licensing Program Analyst (LPA), Miguel Herrera conducted an unannounced complaint inspection to provide findings. LPA met with Director, Elizabed Gonzalez. A tour of the facility was conducted, and a census was taken.
This complaint investigation was completed by Investigator, Ruben Munoz with the Department of Social Services Community Care Licensing Investigations Branch (IB). During the course of the investigation IB Investigator Munoz conducted observations, interviewed facility staff, parents and other relevant involved parties. IB Investigator Munoz also obtained and reviewed facility records, police reports and medical records.
Based on the investigation completed by Investigator Munoz, Child 1 (C1) sustained a crushing injury to the left ring finger, that consisted with a portion of the nail being removed and soft fatty tissue being visible.
Based on the information gathered through interviews and records review the preponderance of evidence standard has been met; therefore, the above allegation is found to be SUBSTANTIATED.
(Continued on LIC9099-C)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Miguel Herrera
LICENSING EVALUATOR SIGNATURE:

DATE: 06/26/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 5
Control Number 04-CC-20250317082050
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: INCLUSION LEARNING CENTER-CLOVIS HILLS CHURCH
FACILITY NUMBER: 103810257
VISIT DATE: 06/26/2025
NARRATIVE
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Per California Code of Regulation, Title 22, Division 12 Chapter 1 the following deficiency is being cited please see attached LIC 9099-D. Director Elizabed Gonzalez was provided a copy of appeal rights.
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 LIC 9224 was given to Director Elizabed Gonzalez. A notice of site visit was given and must remain posted for 30 days. A civil penalty of $2,500 is being assessed and issued. Exit interview conducted and report was reviewed with the Director Elizabed Gonzalez.
SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Miguel Herrera
LICENSING EVALUATOR SIGNATURE:

DATE: 06/26/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 04-CC-20250317082050
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: INCLUSION LEARNING CENTER-CLOVIS HILLS CHURCH
FACILITY NUMBER: 103810257
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/26/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/26/2025
Section Cited
CCR
101223(a)(2)
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101223(a)(2) Personal Rights
(a) The licensee shall ensure that each child is accorded the following personal rights: (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs.
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Director, Elizabed Gonzalez stated that the facility had a discussion pertaining to active supervision to prevent child injuries. The facility also had a discussion on how to handle behavioral issues using redirection methods. Additionally, the facility is closing and surrendering their license effective 06/27/2025.


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This requirement was not met as evidenced by based on interviews conducted and records review, Child 1(C1) sustained an injury described in the LIC 9099. This poses as an immediate 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.
SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Miguel Herrera
LICENSING EVALUATOR SIGNATURE:

DATE: 06/26/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO CC RO, 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
03/17/2025 and conducted by Evaluator Miguel Herrera
PUBLIC
COMPLAINT CONTROL NUMBER: 04-CC-20250317082050

FACILITY NAME:INCLUSION LEARNING CENTER-CLOVIS HILLS CHURCHFACILITY NUMBER:
103810257
ADMINISTRATOR:MONICA PETERSONFACILITY TYPE:
860
ADDRESS:10590 N WILLOW AVETELEPHONE:
(209) 329-6792
CITY:CLOVISSTATE: CAZIP CODE:
93619
CAPACITY:6CENSUS: 3DATE:
06/26/2025
UNANNOUNCEDTIME BEGAN:
12:50 PM
MET WITH:Elizabed GonzalezTIME COMPLETED:
03:00 PM
ALLEGATION(S):
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Staff did not ensure proper fist aid services were provided to child in care.
INVESTIGATION FINDINGS:
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On June 26, 2025, Licensing Program Analyst (LPA), Miguel Herrera conducted an unannounced complaint inspection to provide findings. LPA met with Director, Elizabed Gonzalez. A tour of the facility was conducted, and a census was taken.
This complaint investigation was completed by Investigator, Ruben Munoz with the Department of Social Services Community Care Licensing Investigations Branch (IB). During the course of the investigation IB Investigator Munoz conducted observations, interviewed facility staff and parents. IB Investigator Munoz also obtained and reviewed facility records, police reports and medical records.
Based on the investigation completed by Investigator Munoz, staff grabbed the first aid and were in the process of rendering first aid and calling 911 when Child’s 1 (C1) grandmother showed up to pick up C1 from care. C1’s grandmother assisted staff by helping wrap C1’s finger and proceeded to take C1 to the doctor.
Continued on 9099-C.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Miguel Herrera
LICENSING EVALUATOR SIGNATURE:

DATE: 06/26/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 04-CC-20250317082050
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: INCLUSION LEARNING CENTER-CLOVIS HILLS CHURCH
FACILITY NUMBER: 103810257
VISIT DATE: 06/26/2025
NARRATIVE
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Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that staff did not provide appropriate first aid treatment; therefore, the allegation is UNSUBSTANTIATED.
Per California Code of Regulations, Title 22, Division 12, Chapter 1, no deficiency cited. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Director Elizabed Gonzalez.
SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Miguel Herrera
LICENSING EVALUATOR SIGNATURE:

DATE: 06/26/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 5