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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 165620175
Report Date: 07/27/2026
Date Signed: 07/27/2026 11:03:18 AM

Unsubstantiated


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
05/19/2026 and conducted by Evaluator Xona Xayavong
PUBLIC
COMPLAINT CONTROL NUMBER: 57-CC-20260519162045
FACILITY NAME:ACOSTA RODRIGUEZ, JESSICA FAMILY CHILD CAREFACILITY NUMBER:
165620175
ADMINISTRATOR:ACOSTA RODRIGUEZ, JESSICAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 903-0018
CITY:HANFORDSTATE: CAZIP CODE:
93230
CAPACITY:14CENSUS: 0DATE:
07/27/2026
UNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Licensee Jessica Acosta RodriguezTIME COMPLETED:
11:30 AM
ALLEGATION(S):
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1) Infant suffered unexplained serious injury at the facility resulting in multiple burns on hand and forearm.
INVESTIGATION FINDINGS:
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On July 27, 2026, Licensing Program Analysts (LPAs) Xona Xayavong and Valentin Hernandez conducted an unannounced complaint inspection. LPAs met with Licensee Jessica Acosta Rodriguez. Licensee is Spanish-speaking, and LPA Hernandez assisted with translation. LPAs toured the facility inside and outside, and a census was taken. LPAs explained that the purpose of the inspection was to deliver findings regarding the above allegation.

On May 22, 2026, LPA Hernandez conducted a 10-day complaint inspection to open the complaint, obtain facility documents, and take photographs of the facility.

Investigation Branch (IB) conducted the investigation. During the course of the investigation, the IB investigator conducted interviews with the licensee, staff, and parent, reviewed relevant documents, and observed the facility. (Continue on LIC 9099-C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Cynthia Brannon
LICENSING EVALUATOR NAME: Xona Xayavong
LICENSING EVALUATOR SIGNATURE:

DATE: 07/27/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2026
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 2
Control Number 57-CC-20260519162045
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: ACOSTA RODRIGUEZ, JESSICA FAMILY CHILD CARE
FACILITY NUMBER: 165620175
VISIT DATE: 07/27/2026
NARRATIVE
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On May 12, 2026, Child #1 (C1) sustained second-degree burns to their left hand and forearm after coming into contact with a hot metal pole in the backyard of Jessica’s daycare home. Information obtained indicated that the weather may have reached approximately 98 degrees Fahrenheit, likely causing the pole to become hot. Information and medical documentation reviewed by the IB investigator were consistent with the reported incident. During the incident, Licensee promptly notified C1’s mother, and ensured the child received medical evaluation.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur; therefore, the allegation is UNSUBSTANTIATED.

Per Title 22, Division 12, Chapter 3 of the California Code of Regulations, no deficiency is being cited during today’s inspection.

Licensee Jessica Acosta Rodriguez was provided a copy of her appeal rights. An exit interview was conducted, and the report was reviewed with Licensee Jessica Acosta Rodriguez. This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit was provided and is required to be posted for 30 days.
SUPERVISORS NAME: Cynthia Brannon
LICENSING EVALUATOR NAME: Xona Xayavong
LICENSING EVALUATOR SIGNATURE:

DATE: 07/27/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2026
LIC9099 (FAS) - (06/04)
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