503810061-9-22-2021-04-CC-AJUZ-C7C2BS-20210929171534

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 503810061
Report Date: 09/22/2021
Date Signed: 09/22/2021 12:50:08 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
07/02/2021 and conducted by Evaluator Stefanie Galvan

PUBLIC

COMPLAINT CONTROL NUMBER: 04-CC-20210702130103

FACILITY NAME:	MAGNOLIA ACADEMY		FACILITY NUMBER:	503810061
ADMINISTRATOR:	DAVINI, JAMI		FACILITY TYPE:	850
ADDRESS:	921 WOODROW AVE		TELEPHONE:	(209) 527-2250
CITY:	MODESTO	STATE: CA	ZIP CODE:	95350
CAPACITY:	96	CENSUS: 7	DATE:	09/22/2021
		UNANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Monika Martin, Director		TIME COMPLETED:	01:30 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff is denying responsible party access to daycare child's records.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

An unannounced complaint visit was conducted today by Licensing Program Analyst (LPA) Stefanie Galvan. LPA met with Director, Monika Martin and toured facility inside and outside. A census was taken. LPA reviewed the above listed allegations with the licensee. The purpose of today’s visit was to close the above complaint investigation. The investigation consisted of interviews with the director and owner, along with record reviews. Copies of facility records including the parent handbook and facility policies were also reviewed. Copies of activity sheets and text message print-outs were reviewed. Although the allegations may have happened or are valid, based on statements received during the investigation, observations and review of records, there is not a preponderance of evidence to prove the alleged violation did or did not occur; therefore, the allegations are UNSUBSTANTIATED.
Per California Code of Regulations, Title 22, Division 12, Chapter 1, no deficiency cited during today's visit. Exit interview was conducted with Director, Monika Martin. A copy of this report along with appeal rights were discussed and given to Monika Martin. A Notice of Site Visit is to be posted for 30 days.

Unsubstantiated

Estimated Days of Completion: 90

SUPERVISORS NAME: Alice Juarez
LICENSING EVALUATOR NAME: Stefanie Galvan
LICENSING EVALUATOR SIGNATURE:	DATE: 09/07/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/07/2021

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 1