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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 503810061
Report Date: 11/07/2025
Date Signed: 11/07/2025 12:55:52 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
11/03/2025 and conducted by Evaluator Erica Pacheco
PUBLIC
COMPLAINT CONTROL NUMBER: 04-CC-20251103150510
FACILITY NAME:MAGNOLIA ACADEMYFACILITY NUMBER:
503810061
ADMINISTRATOR:SANTOS, DANIELLEFACILITY TYPE:
850
ADDRESS:921 WOODROW AVETELEPHONE:
(209) 527-2250
CITY:MODESTOSTATE: CAZIP CODE:
95350
CAPACITY:96CENSUS: 30DATE:
11/07/2025
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Danielle SantosTIME COMPLETED:
01:15 PM
ALLEGATION(S):
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Staff left a child in soiled clothing for a long period of time.
INVESTIGATION FINDINGS:
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On 11/07/2025, Licensing Program Analyst (LPA) Erica Pacheco arrived at the facility to conduct an unannounced complaint investigation to gather information to investigate the above allegation. LPA met with Director Danielle Santos. A tour of the facility inside and outside was conducted and census was taken. LPA explained the allegation to Director.

LPA investigated the above allegation. During today’s inspection investigation, interviews were conducted with staff, observations were made, and pertinent records were obtained. After interviews, it was determined that Child #1 was left in soiled clothing for an undetermined amount of time. This is a violation of the child’s personal rights.

Based on interviews, the preponderance of the evidence standard has been met; therefore, the above allegation is found to be SUBSTANTIATED. (continued on 9099-C)
Substantiated
Estimated Days of Completion: 60
SUPERVISORS NAME: Kari McWilliams
LICENSING EVALUATOR NAME: Erica Pacheco
LICENSING EVALUATOR SIGNATURE:

DATE: 11/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2025
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 3
Control Number 04-CC-20251103150510
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: MAGNOLIA ACADEMY
FACILITY NUMBER: 503810061
VISIT DATE: 11/07/2025
NARRATIVE
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Per California Code of Regulations, Title 22, Division 12, Chapter 1, the deficiency is cited on the attached LIC 9099D.

An exit interview conducted with Director Danielle Santos. A copy of this report and Appeal Rights were provided and discussed with Director.

A Notice of Site Visit Form was posted to parent's board and must remain posted for 30 days.
SUPERVISORS NAME: Kari McWilliams
LICENSING EVALUATOR NAME: Erica Pacheco
LICENSING EVALUATOR SIGNATURE:

DATE: 11/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 04-CC-20251103150510
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: MAGNOLIA ACADEMY
FACILITY NUMBER: 503810061
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/07/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/05/2025
Section Cited
CCR
101223(a)(3)
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101223 Personal Rights
(a) The licensee shall ensure that each child is accorded the following personal rights: (3)To be free from corporal or unusual punishment... interference with functions of daily living including.. toileting..
This requirement was not met evidence by:
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Since the incident the facility has already implemented a new chart that details the children's toileting information. Director will also conduct training to staff on Personal Rights for children in care and submit attendance log with staff signatures.
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Based on interviews, it was determined that child #1 was left in soiled clothing for an undetermined about of time.
This is a potential risk to the health, safety, or personal rights of children.
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Director will also submit a plan on how the staff will ensure that children are not left in soiled clothing moving forward. Director will provide documentation of the training and plan to LPA by the Plan of Correction due date.
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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: Erica Pacheco
LICENSING EVALUATOR SIGNATURE:

DATE: 11/07/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3