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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 153808615
Report Date: 09/11/2023
Date Signed: 09/11/2023 04:16:50 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
08/21/2023 and conducted by Evaluator Ruby Ocegueda
PUBLIC
COMPLAINT CONTROL NUMBER: 57-CC-20230821092359
FACILITY NAME:TIERRA SERENA CHILD DEVELOPMENT CENTERFACILITY NUMBER:
153808615
ADMINISTRATOR:LORENA PALOMOFACILITY TYPE:
850
ADDRESS:17213 CENTRAL VALLEY HWYTELEPHONE:
(661) 746-0671
CITY:SHAFTERSTATE: CAZIP CODE:
93263
CAPACITY:60CENSUS: 0DATE:
09/11/2023
UNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Lorena PalomoTIME COMPLETED:
04:45 PM
ALLEGATION(S):
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Staff allowed day care child to leave with the wrong authorized representative
INVESTIGATION FINDINGS:
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On 9/11/2023, Licensing Program Analyst (LPA) Ruby Ocegueda conducted an unannounced complaint inspection at the facility. LPA met with Center Director Lorena Palomo. The purpose of the inspection was to deliver the finding for the above listed complaint allegation. A tour of the facility was conducted and census was taken. There were no children in care at the time of the inspection due to early release.

During the course of the investigation, LPA Ocegueda collected facility records and conducted multiple interviews of the facility representatives, on site staff, parents and adult witnesses. Records and interviews revealed that on 8/14/2023 child #1 was released to adult #1 who is an unrelated unauthorized representative of child #1. Adult #1 is listed as an authorized person who could pick up a different child enrolled at the facility (child #2). Records show that Adult #1 signed out the correct child (child #2). Interviews revealed however that staff #1 released child #1 to adult #1 instead and that adult #1 walked outside with child #1. Upon realizing that it was the wrong child he/she had picked up, adult #1 took child #1 back inside through lobby and the L shaped hallway to his/her classroom located in the back of the center. Interviews revealed that there was an approximately 1 minute to 1.5 minute absence of supervision.


Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Susie Fanning
LICENSING EVALUATOR NAME: Ruby Ocegueda
LICENSING EVALUATOR SIGNATURE:

DATE: 09/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2023
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 57-CC-20230821092359
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: TIERRA SERENA CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 153808615
VISIT DATE: 09/11/2023
NARRATIVE
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This agency investigated the complaint alleging that “Staff allowed day care child to leave with the wrong authorized representative” and has determined that the complaint allegation was SUBSTANTIATED, meaning the preponderance of evidence standard has been met.

An exit interview was conducted with Center Director Lorraine Palomo.

Per California Code of Regulations, Title 22, Division 12, Chapter 1, the following deficiency was cited: (see 9099-D). A 500.00 immediate civil penalty was assessed. Appeal Rights were provided today.

Upon receipt of a Type A violation, facility staff 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 Center Director Palomo.

Notice of Site Visit LIC 9213 must be posted for 30 days.
SUPERVISORS NAME: Susie Fanning
LICENSING EVALUATOR NAME: Ruby Ocegueda
LICENSING EVALUATOR SIGNATURE:

DATE: 09/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 57-CC-20230821092359
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: TIERRA SERENA CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 153808615
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/11/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/12/2023
Section Cited
CCR
101212(a)(1)
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(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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Today, facility representative confirmed that a training was conducted with all facility staff that reviewed topics of sign in and out procedures and supervision. Proof of agenda and notes were provided to the Department on 8/28/2023. A signed agenda by each attending staff will also be provided to Department by POC date 9/12/2023. Facility representatives will also be invited to the Fresno Regional Office to discuss this incident further.
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This requirement was not met as evidenced by: interviews and record review. On 8/14/2023, staff #1 released child #1 to an unauthorized representative (adult #1) causing an absence of supervision when adult #1 walked outside with child #1. This poses an immediate risk to the health, safety and or personal rights of children in care. A 500.00 civil penalty was assessed today.
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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: Susie Fanning
LICENSING EVALUATOR NAME: Ruby Ocegueda
LICENSING EVALUATOR SIGNATURE:

DATE: 09/11/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2023
LIC9099 (FAS) - (06/04)
Page: 5 of 5