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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 503810176
Report Date: 07/11/2025
Date Signed: 07/11/2025 12:37:56 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
06/03/2025 and conducted by Evaluator Erica Pacheco
PUBLIC
COMPLAINT CONTROL NUMBER: 04-CC-20250603154309
FACILITY NAME:DAVIS PARK CHRISTIAN ACADEMY INCFACILITY NUMBER:
503810176
ADMINISTRATOR:ELLIS, ANGELAFACILITY TYPE:
850
ADDRESS:901 W RUMBLE RDTELEPHONE:
(209) 642-0597
CITY:MODESTOSTATE: CAZIP CODE:
95350
CAPACITY:60CENSUS: 18DATE:
07/11/2025
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Angela MadridTIME COMPLETED:
12:50 PM
ALLEGATION(S):
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Staff are not following reporting requirements
INVESTIGATION FINDINGS:
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On 07/11/2025, Licensing Program Analyst (LPA) Erica Pacheco conducted an unannounced complaint inspection to provide findings regarding the above allegation. LPA met with Director Angela Madrid, toured the facility inside and outside and a census was taken. LPA explained and discussed the allegation and finding with Director.

During the course of the investigation, LPA interviewed staff, parents, conducted facility observations, and reviewed and obtained facility records. After interviews and review of records, it was determined in May 2025 the facility had three confirmed cases of Hand Foot Mouth disease. The facility failed to report to Licensing that there was an outbreak of a contagious virus at their facility. Based on LPA's interviews and record review, the preponderance of the evidence standard has been met; therefore, the above allegation is found to be SUBSTANTIATED.

Substantiated
Estimated Days of Completion: 60
SUPERVISORS NAME: Kari McWilliams
LICENSING EVALUATOR NAME: Erica Pacheco
LICENSING EVALUATOR SIGNATURE:

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

DATE: 07/11/2025
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 4
Control Number 04-CC-20250603154309
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: DAVIS PARK CHRISTIAN ACADEMY INC
FACILITY NUMBER: 503810176
VISIT DATE: 07/11/2025
NARRATIVE
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Per California Code of Regulation, Title 22, Division 12 Chapter 1 the following deficiencies are being cited please see attached LIC 9099-D. Licensee was provided a copy of appeal rights.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Director Angela Madrid.
SUPERVISORS NAME: Kari McWilliams
LICENSING EVALUATOR NAME: Erica Pacheco
LICENSING EVALUATOR SIGNATURE:

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

DATE: 07/11/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 04-CC-20250603154309
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: DAVIS PARK CHRISTIAN ACADEMY INC
FACILITY NUMBER: 503810176
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/11/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/11/2025
Section Cited
CCR
101212(d)(1)(C)
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101212(d)(1)(C) Reporting Requirements (d) Upon the occurrence, ... (d)(1) below, a report shall be made to the Department by telephone or fax within the Department's next working day and during its normal business hours...
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Director stated that Director and designated staff will review video on the ccld.childcarevideos.org website titled, Child Care Reporting Requirements. Licensee will provide the Department with an attendance list of all staff that watched the videoand a written statement
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This requirement was not met as evidenced by: Based on record review and interview. The Department was not notified within the Department's next working day and during normal business hours. This poses a potential risk to the health, safety, or personal rights of children.
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on what the staff have learned and by the 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: 07/11/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 4