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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 153808281
Report Date: 08/22/2024
Date Signed: 08/22/2024 10:56:29 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO SOUTH 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
06/27/2024 and conducted by Evaluator Octavia Nolan
COMPLAINT CONTROL NUMBER: 57-CC-20240627163217
FACILITY NAME:NOAHS ARK LEARNING CENTER/PRESCHOOLFACILITY NUMBER:
153808281
ADMINISTRATOR:HERNANDEZ, JENNYFACILITY TYPE:
850
ADDRESS:175 CHESTERTELEPHONE:
(661) 322-0702
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93301
CAPACITY:50CENSUS: DATE:
08/22/2024
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Jenny HernandezTIME COMPLETED:
11:30 AM
ALLEGATION(S):
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Staff did not provide child's authorized representative with incident reports
INVESTIGATION FINDINGS:
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On 08/22/2024, an unannounced inspection was conducted by Licensing Program Analysts (LPAs) Octavia Nolan and Jose Penate. LPAs met with Licensee, Jenny Hernandez. LPAs advised the purpose of the inspection was to close the complaint investigation and provide findings for the above allegations. During the investigation, LPAs interviewed staff, interviewed parents, interviewed children, reviewed facility records, toured the facility, and conducted surveillance.

With the allegation of, staff did not provide child's authorized representative with incident reports, this allegation has been investigated and based off interviews and records review, it was found that staff did not have any incident reports in the sample of child’s files reviewed. During interviews, staff admitted to not keeping incident reports when injuries or incidents occur, although regulations require all children's records of any injury or illness, they must be kept for at least three years following termination of service to the child. A report must be made to the Department by telephone or fax with in the Department’s next working day for any injury of a child that requires medical treatment.

Continued on LIC9099-C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Gloria Reyes
LICENSING EVALUATOR NAME: Octavia Nolan
LICENSING EVALUATOR SIGNATURE:

DATE: 08/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2024
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 4
Control Number 57-CC-20240627163217
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO SOUTH CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: NOAHS ARK LEARNING CENTER/PRESCHOOL
FACILITY NUMBER: 153808281
VISIT DATE: 08/22/2024
NARRATIVE
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This agency has investigated the complaint allegation. After interviews and records review the preponderance of evidence standard has been met; therefore, the above allegations are found to be SUBSTANTIATED.

Type B deficiency was cited.

Per California Code of Regulations Title 22, Division 12, deficiency to be cited (See LIC9099-D).

Exit interview conducted with Licensee Jenny Hernandez. POC/ Appeal Rights were given and discussed.
A Notice of Site Visit Form was posted and must remain posted for 30 days.
SUPERVISORS NAME: Gloria Reyes
LICENSING EVALUATOR NAME: Octavia Nolan
LICENSING EVALUATOR SIGNATURE:

DATE: 08/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 57-CC-20240627163217
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: NOAHS ARK LEARNING CENTER/PRESCHOOL
FACILITY NUMBER: 153808281
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/22/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/22/2024
Section Cited
CCR
101221
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101221 Child's Records
(d) All children's records shall be available to the Department to inspect, audit, and copy upon demand during normal business hours. Records may be removed if necessary for copying. Removal of records shall be subject to the following requirements:
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Licensee has conducted an all staff training/meeting on procedures to provide parents and authorized representatives with incidents reports. The licensee plans to review Child’s Records Requirements and Reporting Requirements. She understands that she is to report any injury
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(D) Records of any current illness or injury as specified in Section 101221(a)(9). (9) Record of any illness or injury requiring treatment by a physician or dentist and for which the center provided assistance to the child in meeting his/her necessary medical or dental needs. This requirement was not met as evidence by interviews and records review. This is a potential health and safety risk to children in care.
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to a child that requires medical treatment to the department within the Department’s next working day. In addition, a written report containing the information shall be submitted to the Department within seven business days following the occurrence of such event.
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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: Gloria Reyes
LICENSING EVALUATOR NAME: Octavia Nolan
LICENSING EVALUATOR SIGNATURE:

DATE: 08/22/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 4