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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153810054
Report Date: 02/26/2024
Date Signed: 02/26/2024 01:37:44 PM

Document Has Been Signed on 02/26/2024 01:37 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 SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:PANAMA-BUENA VISTA USD-MILLER PRE-KFACILITY NUMBER:
153810054
ADMINISTRATOR:HOGG, STACYFACILITY TYPE:
850
ADDRESS:7345 MOUNTAIN RIDGE DRTELEPHONE:
(661) 831-8331
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93313
CAPACITY: 48TOTAL ENROLLED CHILDREN: 48CENSUS: 43DATE:
02/26/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Dionnne WoodTIME COMPLETED:
02:00 PM
NARRATIVE
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On February 26, 2024 Licensing Program Analysts (LPAs) Kari McWilliams and Behatriz Gonzalez conducted an unannounced Plan of Correction (POC) inspection and met with Director Dionne Wood. LPAs informed Director Wood the purpose of the inspection and toured the facility inside and out and a census was taken.

On January 24, 2024 LPA McWilliams conducted a unannounced annual inspection and observed during staff file reviews that the facility could not provide all staff files with all required information as well as the facility could not provide current mandated reporter training certificates.

During todays inspection LPAs McWilliams and Gonzalez confirmed all staff have current certificates of completed mandated reporter training that meet AB1207 requirements. LPAs went to Panama-Buena Vista School District to review staff files and noted that staff files were incomplete. LPAs went over required paperwork with the school district personnel from human resources and provided Director Woods with an entrance checklist of the forms needed.

Exit interview conducted and report was reviewed with facility representative Director Woods. Appeal rights were provided.

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, the following deficiency is being cited: (see next page).


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: Luisa Gavoutian
LICENSING EVALUATOR NAME: Kari McWilliams
LICENSING EVALUATOR SIGNATURE: DATE: 02/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/26/2024
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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Document Has Been Signed on 02/26/2024 01:37 PM - It Cannot Be Edited


Created By: Kari McWilliams On 02/26/2024 at 01:16 PM
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: PANAMA-BUENA VISTA USD-MILLER PRE-K
FACILITY NUMBER: 153810054

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/26/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/19/2024
Section Cited
CCR
101217(a)

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(a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information:

This requirement is not met as evidenced by:
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Director states that she will obtain the required forms and have complete staff files readibly available for licensing by the above POC date when LPA conducts a plan of correction inspection.
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Based on record review, the licensee did not comply with the section cited above in 5 out of 8 staff did not have complete staff files readibly available which poses/posed a potential health, safety or personal rights risk to persons 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:Luisa Gavoutian
LICENSING EVALUATOR NAME:Kari McWilliams
LICENSING EVALUATOR SIGNATURE:
DATE: 02/26/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/26/2024


LIC809 (FAS) - (06/04)
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