503810109-3-18-2021-04-CC-LGAN-BZ8QCQ-20210318120332

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 503810109
Report Date: 03/18/2021
Date Signed: 03/18/2021 12:03:43 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME:	KIDS' COMMUNITY CAMPUS		FACILITY NUMBER:	503810109
ADMINISTRATOR:	MENDOZA, EUNICE G		FACILITY TYPE:	830
ADDRESS:	2490 N WALNUT RD		TELEPHONE:	(209) 620-8389
CITY:	TURLOCK	STATE: CA	ZIP CODE:	95382
CAPACITY:	24	CENSUS: 6	DATE:	03/18/2021
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME BEGAN:	09:40 AM
MET WITH:	Licensee - Eunice Mendoza		TIME COMPLETED:	12:15 PM

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25

On 03/18/2021, Licensing Program Analysts (LPAs) Luisa Gavoutian and Roman Iglesias conducted an unannounced Case Management inspection. LPAs met with Licensee/Director Eunice Mendoza, toured the facility, and took a census. The purpose of today’s inspection was to discuss an incident that was reported to Community Care Licensing (CCL) on 02/05/2021, where Child 1 was handled roughly.

On 02/13/2021, Licensee submitted footage of the incident from the security camera in the infant classroom, Room 4. The infant classroom is divided by low shelving and child safety gates into Room 4A and 4B. LPA Gavoutian observed several health and safety concerns in the video footage. Child 1 was crying, and Staff 1 had been called into Room 4B to provide a diaper change to Child 1. Staff 1 was reluctant to change Child 1’s diaper and remained in Room 4A engaged in conversation with Licensee regarding her reluctance to do so. On several occasions, Child 1 and Child 2, who was laying down behind the partition, were left alone in Room 4B without adult supervision. Licensee, Staff 1, and Staff 2 were in Room 4A, had their backs facing Room 4B, and were not supervising Child 1 and Child 2.

Staff 3 heard Child 1 crying from another classroom and arrived to Room 4B to assist with the situation. Staff 3 sat on the ground and carried Child 1 on Staff 3’s lap to console the child. At this time, video footage shows Staff 1 and Staff 3 engaged in a verbal altercation, which was witnessed by Licensee, staff, and children.

Staff 1 and Staff 3 were engaged in a verbal altercation when Staff 3 roughly placed Child 1 onto the floor in front of Staff 1’s feet; Child 1 was placed on Child 1’s bottom, but fell back into a laying position on the floor. Immediately, both Staff 1 and Staff 3 hastily exited Room 4B, once again leaving Child 1 without supervision and crying. Staff 1 approached Licensee in Room 4A and Staff 3 exited Classroom 4. Licensee stated that Child 1 had been checked for marks or bruises and no injury was sustained.

(Continued on LIC 809-C)

SUPERVISOR'S NAME: Alice Juarez	TELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Luisa Gavoutian	TELEPHONE: (559) 341-4725
LICENSING EVALUATOR SIGNATURE:	DATE: 03/18/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/18/2021

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: KIDS' COMMUNITY CAMPUS	FACILITY NUMBER: 503810109
	VISIT DATE: 03/18/2021

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Today, Licensee is being issued an immediate $500.00 civil penalty in violation of California Code of Regulations (CCR) Section 101429(a)(1), which states: “Each infant shall be constantly supervised and under direct visual observation and supervision by a staff person at all times.” The civil penalty is being issued through the authority of Health and Safety Code Section 1596.99(c)(3), which states: “(c) The department shall assess an immediate civil penalty of five hundred dollars ($500) per violation and one hundred dollars ($100) for each day the violation continues after citation, for any of the following serious violations: (3) Absence of supervision, including, but not limited to, a child left unattended, and supervision of a child by a person under 18 years of age.”

Per Chapter 1, Division 12, Title 22 of the California Code of Regulations, the following deficiencies are found: (see LIC809-D). Exit interview was conducted with Licensee Eunice Mendoza. Licensee was provided a copy of appeal rights.

"Upon receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months."

A copy of the Fact Sheet - AB 633 Child Care Parent Notification Requirements and a copy of LIC 9224 was given to licensee.

This report shall be made available to the public upon request.
LIC9213 Notice of Site Visit is required to be posted for 30 days.

SUPERVISOR'S NAME: Alice Juarez	TELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Luisa Gavoutian	TELEPHONE: (559) 341-4725
LICENSING EVALUATOR SIGNATURE:	DATE: 03/18/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/18/2021

LIC809 (FAS) - (06/04)

Page: 2 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: KIDS' COMMUNITY CAMPUS	FACILITY NUMBER: 503810109
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/18/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 04/01/2021 Section Cited	1 2 3 4 5 6 7	Personal Rights; (a) The licensee shall ensure that each child is accorded the following personal rights: (1) To be accorded dignity in his/her personal relationships with staff and other persons. This requirement was not met as evidenced by:
	8 9 10 11 12 13 14	Based on observation, Licensee failed to ensure the appropriate handling of Child 1. Video footage was viewed and LPA Gavoutian observed Staff 3 roughly placing Child 1 on the floor. This poses an immediate risk to the health, safety, and personal rights of children.	8 9 10 11 12 13 14
Type A 04/01/2021 Section Cited	1 2 3 4 5 6 7	Responsibility for Providing Care and Supervision for Infants; Each infant shall be constantly supervised and under direct visual observation and supervision by a staff person at all times. This requirement was not met as evidenced by: Based on observation, video
	8 9 10 11 12 13 14	footage viewed by LPA Gavoutian revealed Child 1 and Child 2 were left without supervision behind the partition in Classroom 4, as described in LIC 809. This poses an immediate risk to the health, safety, or personal rights of children. An immediate $500.00 civil penalty is being assessed.	8 9 10 11 12 13 14

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: Alice Juarez	TELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Luisa Gavoutian	TELEPHONE: (559) 341-4725
LICENSING EVALUATOR SIGNATURE:	DATE: 03/18/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/18/2021

LIC809 (FAS) - (06/04)

Page: 3 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: KIDS' COMMUNITY CAMPUS	FACILITY NUMBER: 503810109
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/18/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 04/01/2021 Section Cited	1 2 3 4 5 6 7	Conduct which is inimical to the health, morals, welfare, or safety of either an individual in or receiving services from the facility or the people of this state. This requirement was not met as evidenced by:
	8 9 10 11 12 13 14	Based on observation, video footage viewed by LPA Gavoutian revealed that Staff 1 and Staff 3 were engaged in a verbal altercation, witnessed by staff and daycare children. This poses an immediate risk to the health, safety, and personal rights of children.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7
	1 2 3 4 5 6 7

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: Alice Juarez	TELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Luisa Gavoutian	TELEPHONE: (559) 341-4725
LICENSING EVALUATOR SIGNATURE:	DATE: 03/18/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/18/2021

LIC809 (FAS) - (06/04)

Page: 4 of 4