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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 503808634
Report Date: 03/19/2024
Date Signed: 03/19/2024 04:26:09 PM

Document Has Been Signed on 03/19/2024 04:26 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 CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:SEQUOIA PRESCHOOL ACADEMYFACILITY NUMBER:
503808634
ADMINISTRATOR:GUTHMILLER, JANETFACILITY TYPE:
850
ADDRESS:1308 COFFEE ROADTELEPHONE:
(209) 526-2273
CITY:MODESTOSTATE: CAZIP CODE:
95355
CAPACITY: 30TOTAL ENROLLED CHILDREN: 30CENSUS: 0DATE:
03/19/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Janet GuthmillerTIME COMPLETED:
05:00 PM
NARRATIVE
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On 03/19/2024, Licensing Program Analyst (LPA) Valerie Mireles conducted an unannounced Case Management inspection to address the law enforcement contact at the facility on 03/08/2024. LPA met with Director Janet Guthmiller while facility was closed during spring break, no children were present. LPA provided Director reporting requirements and LIC624. Licensee failed to report by telephone or by fax to Community Care Licensing within 24 hours of the law enforcement contact on 03/08/2024; therefore, is in violation of the California Code of Regulations 101212(d)(1)(C). LPA reviewed facility records and it was determined that facility did not have a current roster of children; therefore is in violation of Health & Safety Code 1596.841.

Per California Code of Regulations, Title 22, Division 12, Chapter 1, the following deficiencies are being cited on the attached LIC 809-D. Director Janet Guthmiller was provided with appeal rights.

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. Exit interview conducted and report was reviewed with Director Janet Guthmiller.
SUPERVISORS NAME: Cynthia Brannon
LICENSING EVALUATOR NAME: Valerie Mireles
LICENSING EVALUATOR SIGNATURE: DATE: 03/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/19/2024
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 is an Amendment of Original Document on 11/06/2024 01:35 PM


Created By: Valerie Mireles On 03/19/2024 at 10:51 AM
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
FRESNO CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: SEQUOIA PRESCHOOL ACADEMY
FACILITY NUMBER: 503808634

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/19/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Deficiency Dismissed




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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:Cynthia Brannon
LICENSING EVALUATOR NAME:Valerie Mireles
LICENSING EVALUATOR SIGNATURE:
DATE: 03/19/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/19/2024


LIC809 (FAS) - (06/04)
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