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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 223911233
Report Date: 03/12/2026
Date Signed: 03/12/2026 05:10:00 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO 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
02/17/2026 and conducted by Evaluator Martha DeHaro
PUBLIC
COMPLAINT CONTROL NUMBER: 04-CC-20260217103319
FACILITY NAME:HENDERSON, SHANNON FAMILY CHILD CAREFACILITY NUMBER:
223911233
ADMINISTRATOR:HENDERSON, SHANNONFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 617-9767
CITY:CATHEYS VALLEYSTATE: CAZIP CODE:
95306
CAPACITY:14CENSUS: 0DATE:
03/12/2026
UNANNOUNCEDTIME BEGAN:
04:15 PM
MET WITH:Shannon HendersonTIME COMPLETED:
05:30 PM
ALLEGATION(S):
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Uncleared adult was residing in the home
INVESTIGATION FINDINGS:
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On 3/12/2026, Licensing Program Analyst (LPA) Martha De Haro, Licensing Program Manager (LPM) Jose Penate, and Regional Manager (RM) Susie Fanning conducted an unannounced complaint inspection and met with Licensee Shannon Henderson. The purpose of this inspection was to advise licensee of the above allegation and provide findings. The above allegation was explained to Licensee.

During the course of the investigation, LPA De Haro and Investigator Shelley Faulconer from the Investigations Branch (IB) reviewed files, conducted interviews, and obtained documents including pertinent records and reports.

The allegation that an uncleared adult was residing in the home is SUBSTANTIATED as the evidence revealed that licensee’s adult relative resided in the home without receiving the required criminal record clearance or exemption. The preponderance of evidence has been met. (Continued on LIC 9099-C)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kari McWilliams
LICENSING EVALUATOR NAME: Martha DeHaro
LICENSING EVALUATOR SIGNATURE:

DATE: 03/12/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2026
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 5
Control Number 04-CC-20260217103319
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: HENDERSON, SHANNON FAMILY CHILD CARE
FACILITY NUMBER: 223911233
VISIT DATE: 03/12/2026
NARRATIVE
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Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following deficiency is being cited: (see next page). A civil penalty was also assessed.

Licensee was provided appeal rights.

LPA De Haro informed licensee Shannon Henderson that this report dated 03/12/2026 documents one (1) Type A citation which shall be posted for 30 consecutive days as there are immediate risks to the health, safety, or personal rights of children in care. Also, LPA De Haro informed the licensee to provide a copy of this licensing report dated 03/12/2026 that documents any Type A citations to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

A copy of the Fact Sheet - Child Care Parent Notification Requirements and a copy of LIC 9224 Acknowledgement of Receipt of Licensing Reports was given to Licensee.

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: Kari McWilliams
LICENSING EVALUATOR NAME: Martha DeHaro
LICENSING EVALUATOR SIGNATURE:

DATE: 03/12/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2026
LIC9099 (FAS) - (06/04)
Page: 5 of 5
Control Number 04-CC-20260217103319
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: HENDERSON, SHANNON FAMILY CHILD CARE
FACILITY NUMBER: 223911233
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/12/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/12/2026
Section Cited
CCR
102370(d)(1)
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Criminal Record Clearance - (d) All individuals subject to a criminal record review...shall prior to working, residing, or volunteering in a licensed facility:
(1) Obtain a California clearance or a criminal record exemption as required by the Department
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A Temporary Suspension order was served on 03/12/2026.
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This requirement was not met as evidenced by interviews confirming that an uncleared adult lived in the home and/or provided care and supervision including transportation to children in care. This poses an immediate risk to the health, safety and personal rights of children 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.
SUPERVISORS NAME: Kari McWilliams
LICENSING EVALUATOR NAME: Martha DeHaro
LICENSING EVALUATOR SIGNATURE:

DATE: 03/12/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO 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
02/17/2026 and conducted by Evaluator Martha DeHaro
PUBLIC
COMPLAINT CONTROL NUMBER: 04-CC-20260217103319

FACILITY NAME:HENDERSON, SHANNON FAMILY CHILD CAREFACILITY NUMBER:
223911233
ADMINISTRATOR:HENDERSON, SHANNONFACILITY TYPE:
810
ADDRESS:4783A SCHOOLHOUSE RDTELEPHONE:
(209) 617-9767
CITY:CATHEYS VALLEYSTATE: CAZIP CODE:
95306
CAPACITY:14CENSUS: 0DATE:
03/12/2026
UNANNOUNCEDTIME BEGAN:
04:15 PM
MET WITH:Shannon HendersonTIME COMPLETED:
05:30 PM
ALLEGATION(S):
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Licensee was smoking on the premises during hours of care
INVESTIGATION FINDINGS:
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On 3/12/2026, Licensing Program Analyst (LPA) Martha De Haro, Licensing Program Manager (LPM) Jose Penate, and Regional Manager (RM) Susie Fanning conducted an unannounced complaint inspection and met with Licensee Shannon Henderson. The purpose of this inspection was to advise licensee of the above allegation and provide findings. The above allegation was explained to Licensee.

During the course of the investigation, LPA De Haro and Investigator Shelley Faulconer from the Investigations Branch (IB) reviewed files, conducted interviews, and obtained documents including pertinent records and reports.

Although the allegation may have happened or is valid, the findings are UNSUBSTANTIATED. The preponderance of evidence standard has not been met with regard to licensee smoking and/or vaping inside the family child care home during day care hours. (Continued on LIC 9099-C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kari McWilliams
LICENSING EVALUATOR NAME: Martha DeHaro
LICENSING EVALUATOR SIGNATURE:

DATE: 03/12/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 04-CC-20260217103319
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: HENDERSON, SHANNON FAMILY CHILD CARE
FACILITY NUMBER: 223911233
VISIT DATE: 03/12/2026
NARRATIVE
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No deficiency is being cited.

Exit interview conducted with Licensee Shannon Henderson. 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.

Licensee was provided appeal rights.

SUPERVISORS NAME: Kari McWilliams
LICENSING EVALUATOR NAME: Martha DeHaro
LICENSING EVALUATOR SIGNATURE:

DATE: 03/12/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2026
LIC9099 (FAS) - (06/04)
Page: 4 of 5