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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 503808634
Report Date: 06/05/2024
Date Signed: 06/05/2024 01:17:11 PM

Document Has Been Signed on 06/05/2024 01:17 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/
DIRECTOR:		GUTHMILLER, JANETFACILITY TYPE:
850
ADDRESS:1308 COFFEE ROADTELEPHONE:
(209) 526-2273
CITY:MODESTOSTATE: CAZIP CODE:
95355
CAPACITY: 30TOTAL ENROLLED CHILDREN: 30CENSUS: 17DATE:
06/05/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:15 AM
MET WITH:Janet GuthmillerTIME VISIT/
INSPECTION COMPLETED:
01:45 PM
NARRATIVE
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On 06/05/2024, Licensing Program Analyst (LPA) Valerie Mireles conducted an unannounced case management inspection for the preschool license. LPA met with Director, Janet Guthmiller and a census was taken. There were 17 preschool children present during today's inspection being supervised by two fully qualified teachers. LPA toured the facility, inside and outside.

During today’s inspection, LPA reviewed the sign in and out sheets for 06/05/2024. LPA observed Child #2 already signed in and out from 06/03/2024 through 06/07/2024, which poses a potential health and safety risk to children in care.

Exit interview conducted with the Director, Janet Guthmiller. Per California Code of Regulations, Title 22, Division 12, Chapter 1, this deficiency is cited on the attached LIC 809D. 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: Cynthia Brannon
LICENSING EVALUATOR NAME: Valerie Mireles
LICENSING EVALUATOR SIGNATURE: DATE: 06/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/05/2024
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 06/05/2024 01:17 PM - It Cannot Be Edited


Created By: Valerie Mireles On 06/05/2024 at 11:46 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
, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: SEQUOIA PRESCHOOL ACADEMY
FACILITY NUMBER: 503808634

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/05/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/14/2024
Section Cited
CCR
101229.1(b)

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101229.1(b) Sign In and Sign Out (b) The person who brings the child to, and removes the child from, the center shall sign the child in/out.
This requirement was not met as evidenced by:
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Director will provide a reminder notice to parents and will provide a copy of the notice form to CCL via e-mail by end of business day on 06/14/2024.
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During a review of facility records, on 06/05/2024, LPA Valerie Mireles observed Child #2 already signed in and out from 06/03/2024 through 06/07/2024.
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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: 06/05/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/05/2024


LIC809 (FAS) - (06/04)
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