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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 153910671
Report Date: 04/18/2023
Date Signed: 04/18/2023 12:22:42 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
03/16/2023 and conducted by Evaluator Candis Rodriguez
PUBLIC
COMPLAINT CONTROL NUMBER: 57-CC-20230316132003
FACILITY NAME:BORJON-COSBY, CYNTHIA FAMILY CHILD CAREFACILITY NUMBER:
153910671
ADMINISTRATOR:BORJON-COSBY, CYNTHIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 444-2667
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93311
CAPACITY:14CENSUS: 9DATE:
04/18/2023
UNANNOUNCEDTIME BEGAN:
11:40 AM
MET WITH:Cynthia Borjon-CosbyTIME COMPLETED:
12:45 PM
ALLEGATION(S):
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Lack of supervision resulting in day care child being bitten by other child while in care.
INVESTIGATION FINDINGS:
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On 04/18/2023, Licensing Program Analyst (LPA) Candis Rodriguez conducted an unannounced complaint inspection at facility. LPA met with Licensee Cynthia Borjon-Cosby, explained the purpose of inspection, toured the facility, and took a census.

Investigation revealed through interviews with Parent #1 and Parent #2 and document review that Child #1 was bit by Child #2 while in care at the facility. Investigation also revealed through interview with Parent #1 and Parent #2 and document review that Licensee was aware there was an incident between Child #1 and Child #2, but did not see bite marks on Child #1, learning of the injury after Parent #1 reported it to Licensee.
Investigation revealed through interview that Licensee works with Parent #2 to assist Child #2 in learning other means of communication. (Continued on LIC 9099-C)
Substantiated
Estimated Days of Completion: 0
SUPERVISORS NAME: Susie Fanning
LICENSING EVALUATOR NAME: Candis Rodriguez
LICENSING EVALUATOR SIGNATURE:

DATE: 04/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2023
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-20230316132003
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: BORJON-COSBY, CYNTHIA FAMILY CHILD CARE
FACILITY NUMBER: 153910671
VISIT DATE: 04/18/2023
NARRATIVE
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This Department investigated the allegation of Lack of supervision resulting in day care child being bitten by other child while in care, and through interview and document review confirmed the allegation did occur at the facility. Therefore, the preponderance of evidence standard has been met, and the allegation is found to be Substantiated.

Per California Code of Regulations, Title 22, Division 12, Chapter 1, the following deficiency was cited (see LIC 9099-D).

An Exit interview was conducted with Licensee. Appeal Rights were provided.

Copy of Notice of Site Visit LIC 9213 will be posted for 30 days.
SUPERVISORS NAME: Susie Fanning
LICENSING EVALUATOR NAME: Candis Rodriguez
LICENSING EVALUATOR SIGNATURE:

DATE: 04/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 57-CC-20230316132003
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: BORJON-COSBY, CYNTHIA FAMILY CHILD CARE
FACILITY NUMBER: 153910671
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/18/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/16/2023
Section Cited
CCR
102423(a)(1)
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102423(a) Each child receiving services from a family child care home shall have certain rights that shall not be waived or abridged by the licensee regardless of consent or authorization from the child's authorized representative. These rights include, but are not limited to, the following: (1) To be treated with dignity in his/her personal relationship with staff and other persons.
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Licensee stated she has addressed her assistants and also older children about what to do and what to look for while Licensee works with Child #2 to prevent biting. Licensee works with parent of Child #2 and communicates best practices.
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This requirement was not met as evidenced by: Based on interviews and document review, Child #1 was bit by Child #2 while in care. This poses a potential risk to the health, safety, and personal rights of children in care.
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Licensee agreed to continue monitoring and assisting Child #2 and have herself or assistant shadow Child #2 when around other younger children to prevent incidents from occurring.
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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: Candis Rodriguez
LICENSING EVALUATOR SIGNATURE:

DATE: 04/18/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2023
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 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
03/16/2023 and conducted by Evaluator Candis Rodriguez
PUBLIC
COMPLAINT CONTROL NUMBER: 57-CC-20230316132003

FACILITY NAME:BORJON-COSBY, CYNTHIA FAMILY CHILD CAREFACILITY NUMBER:
153910671
ADMINISTRATOR:BORJON-COSBY, CYNTHIAFACILITY TYPE:
810
ADDRESS:5217 AU CHOCOLAT DRTELEPHONE:
(661) 444-2667
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93311
CAPACITY:14CENSUS: 9DATE:
04/18/2023
UNANNOUNCEDTIME BEGAN:
11:40 AM
MET WITH:Cynthia Borjon-CosbyTIME COMPLETED:
12:45 PM
ALLEGATION(S):
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Licensee did not report incidents involving day care child while in care.
INVESTIGATION FINDINGS:
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On 04/18/2023, Licensing Program Analyst (LPA) Candis Rodriguez conducted an unannounced complaint inspection at facility. LPA met with Licensee Cynthia Borjon-Cosby, explained purpose of inspection, toured the facility, and took a census.
Investigation revealed that Child #1 was bit by Child #2 while in care at the facility. Based on interviews with Parent #1 and Parent #2 and document review, Licensee did not see the injury while Child #1 was in care and learned of the injury to Child #1 after Parent #1 reported it to Licensee. Licensee was cited on LIC 9099 complaint inspection report dated 04/18/2023 for Lack of supervision resulting in day care child being bitten by other child while in care, which is a personal rights violation.
Investigation could not reveal that Licensee did not report incidents involving day care child while in care. Therefore, although allegations above may have happened or are valid, there is not a preponderance of evidence to provide the alleged violations did or did not occur, therefore the allegations are Unsubstantiated.
(Continued on LIC 9099-C)
Unsubstantiated
Estimated Days of Completion: 0
SUPERVISORS NAME: Susie Fanning
LICENSING EVALUATOR NAME: Candis Rodriguez
LICENSING EVALUATOR SIGNATURE:

DATE: 04/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2023
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 57-CC-20230316132003
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: BORJON-COSBY, CYNTHIA FAMILY CHILD CARE
FACILITY NUMBER: 153910671
VISIT DATE: 04/18/2023
NARRATIVE
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Per California Code of Regulations, Title 22, Division 12, Chapter 1, no deficiency is cited.

An Exit interview was conducted with Licensee. Appeal Rights were provided.

Copy of Notice of Site Visit LIC 9213 will be posted for 30 days.
SUPERVISORS NAME: Susie Fanning
LICENSING EVALUATOR NAME: Candis Rodriguez
LICENSING EVALUATOR SIGNATURE:

DATE: 04/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2023
LIC9099 (FAS) - (06/04)
Page: 5 of 5