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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 503810061
Report Date: 03/16/2023
Date Signed: 03/16/2023 12:31:28 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO-CC, 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
02/17/2023 and conducted by Evaluator Priscilla Zamudio
PUBLIC
COMPLAINT CONTROL NUMBER: 04-CC-20230217091203

FACILITY NAME:MAGNOLIA ACADEMYFACILITY NUMBER:
503810061
ADMINISTRATOR:DAVINI, JAMIFACILITY TYPE:
850
ADDRESS:921 WOODROW AVETELEPHONE:
(209) 527-2250
CITY:MODESTOSTATE: CAZIP CODE:
95350
CAPACITY:96CENSUS: 58DATE:
03/16/2023
UNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Monika MartinTIME COMPLETED:
12:45 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff yell at day care children.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 3/16/23, Licensing Program Analyst (LPA) conducted an unannounced follow up complaint inspection at the facility. The purpose of the inspection was to deliver investigation findings for the above allegation. LPA met with Director, Monika Martin, and a census was taken. During the course of this investigation, LPA reviewed pertinent records and conducted interviews with staff, parents and children.

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 allegation is 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:
SUPERVISORS NAME: Cynthia Brannon
LICENSING EVALUATOR NAME: Priscilla Zamudio
LICENSING EVALUATOR SIGNATURE:

DATE: 03/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
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