CAL IVY PREP AT CSUB

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25On 10/04/2024, Licensing Program Analysts (LPAs) Nohemi Sanchez and Lady Cabrera conducted an unannounced case management inspection to amend report, LIC 809 dated 09/27/2024. LPAs met with Director Amy Miller and discussed amended report. LPA Sanchez and Amy Miller signed the amended report. During a complaint investigation, LPA Sanchez discovered per records reviewed and interviews, Community Care Licensing (CCL) did not receive an Unusual Incident Report by telephone or fax within the CCL’s next working day and during its normal business hours. Per Assistant Director and Site Supervisor they were not aware of the minimum number of active communicable diseases cases needed to be reported to CCL. Facility did not comply with the reporting requirements regulations. LPA Sanchez reviewed 101212 Reporting Regulations Requirements with Director. Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, the following deficiency is being cited. Director Amy Miller was provided a copy of their appeal rights. This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days. SUPERVISORS NAME: Luisa Gavoutian LICENSING EVALUATOR NAME: Nohemi Sanchez LICENSING EVALUATOR SIGNATURE: DATE: 10/04/2024 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/04/2024 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 2 FACILITY NAME: CAL IVY PREP AT CSUB FACILITY NUMBER: 153810190 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 10/04/2024 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type B 10/18/2024 Section Cited CCR 101212(d) 1 2 3 4 5 6 7101212 Reporting Requirements (d) Upon the occurrence, during the operation of the childcare center of any of the events specified in (d)(1) below, a report shall be made to the Department ...This requirement was not met as evidenced by:1 2 3 4 5 6 7LPA reviewed Reporting Requirements with Licensee and provided a copy. Directed stated they will review 101212 Reporting Requirements regulation and train all Management. Director will submit to the Fresno South Licensing Office a training outline and a sign in sheet by 10/11/2024. 8 9 10 11 12 13 14Based on interviews and records reviewed, Licensee did not comply with the cited regulation, which poses a potential risk to the health, safety, or personal rights to children in care.8 9 10 11 12 13 14 1 2 3 4 5 6 71 2 3 4 5 6 7 1 2 3 4 5 6 71 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:Luisa Gavoutian LICENSING EVALUATOR NAME:Nohemi Sanchez LICENSING EVALUATOR SIGNATURE: DATE: 10/04/2024 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/04/2024

Type A citation - immediate risk to health, safety, or personal rights

Type B citation - potential risk if not corrected

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25On 10/04/2024, Licensing Program Analysts (LPAs) Nohemi Sanchez and Lady Cabrera conducted an unannounced case management inspection to amend report, LIC 809 dated 09/27/2024. LPAs met with Director Amy Miller and discussed amended report. LPA Sanchez and Amy Miller signed the amended report. During a complaint investigation, LPA Sanchez discovered per records reviewed and interviews, Community Care Licensing (CCL) did not receive an Unusual Incident Report by telephone or fax within the CCL’s next working day and during its normal business hours. Per Assistant Director and Site Supervisor they were not aware of the minimum number of active communicable diseases cases needed to be reported to CCL. Facility did not comply with the reporting requirements regulations. LPA Sanchez reviewed 101212 Reporting Regulations Requirements with Director. Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, the following deficiency is being cited. Director Amy Miller was provided a copy of their appeal rights. This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days. SUPERVISORS NAME: Luisa Gavoutian LICENSING EVALUATOR NAME: Nohemi Sanchez LICENSING EVALUATOR SIGNATURE: DATE: 10/04/2024 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/04/2024 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 2 FACILITY NAME: CAL IVY PREP AT CSUB FACILITY NUMBER: 153810190 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 10/04/2024 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type B 10/18/2024 Section Cited CCR 101212(d) 1 2 3 4 5 6 7101212 Reporting Requirements (d) Upon the occurrence, during the operation of the childcare center of any of the events specified in (d)(1) below, a report shall be made to the Department ...This requirement was not met as evidenced by:1 2 3 4 5 6 7LPA reviewed Reporting Requirements with Licensee and provided a copy. Directed stated they will review 101212 Reporting Requirements regulation and train all Management. Director will submit to the Fresno South Licensing Office a training outline and a sign in sheet by 10/11/2024. 8 9 10 11 12 13 14Based on interviews and records reviewed, Licensee did not comply with the cited regulation, which poses a potential risk to the health, safety, or personal rights to children in care.8 9 10 11 12 13 14 1 2 3 4 5 6 71 2 3 4 5 6 7 1 2 3 4 5 6 71 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:Luisa Gavoutian LICENSING EVALUATOR NAME:Nohemi Sanchez LICENSING EVALUATOR SIGNATURE: DATE: 10/04/2024 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/04/2024

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25On 10/04/2024, Licensing Program Analysts (LPAs) Nohemi Sanchez and Lady Cabrera conducted an unannounced case management inspection to amend report, LIC 809 dated 09/27/2024. LPAs met with Director Amy Miller and discussed amended report. LPA Sanchez and Amy Miller signed the amended report. During a complaint investigation, LPA Sanchez discovered per records reviewed and interviews, Community Care Licensing (CCL) did not receive an Unusual Incident Report by telephone or fax within the CCL’s next working day and during its normal business hours. Per Assistant Director and Site Supervisor they were not aware of the minimum number of active communicable diseases cases needed to be reported to CCL. Facility did not comply with the reporting requirements regulations. LPA Sanchez reviewed 101212 Reporting Regulations Requirements with Director. Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, the following deficiency is being cited. Director Amy Miller was provided a copy of their appeal rights. This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days. SUPERVISORS NAME: Luisa Gavoutian LICENSING EVALUATOR NAME: Nohemi Sanchez LICENSING EVALUATOR SIGNATURE: DATE: 10/04/2024 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/04/2024 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 2 FACILITY NAME: CAL IVY PREP AT CSUB FACILITY NUMBER: 153810190 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 10/04/2024 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type B 10/18/2024 Section Cited CCR 101212(d) 1 2 3 4 5 6 7101212 Reporting Requirements (d) Upon the occurrence, during the operation of the childcare center of any of the events specified in (d)(1) below, a report shall be made to the Department ...This requirement was not met as evidenced by:1 2 3 4 5 6 7LPA reviewed Reporting Requirements with Licensee and provided a copy. Directed stated they will review 101212 Reporting Requirements regulation and train all Management. Director will submit to the Fresno South Licensing Office a training outline and a sign in sheet by 10/11/2024. 8 9 10 11 12 13 14Based on interviews and records reviewed, Licensee did not comply with the cited regulation, which poses a potential risk to the health, safety, or personal rights to children in care.8 9 10 11 12 13 14 1 2 3 4 5 6 71 2 3 4 5 6 7 1 2 3 4 5 6 71 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:Luisa Gavoutian LICENSING EVALUATOR NAME:Nohemi Sanchez LICENSING EVALUATOR SIGNATURE: DATE: 10/04/2024 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/04/2024

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25On 10/04/2024, Licensing Program Analysts (LPAs) Nohemi Sanchez and Lady Cabrera conducted an unannounced case management inspection to amend report, LIC 809 dated 09/27/2024. LPAs met with Director Amy Miller and discussed amended report. LPA Sanchez and Amy Miller signed the amended report. During a complaint investigation, LPA Sanchez discovered per records reviewed and interviews, Community Care Licensing (CCL) did not receive an Unusual Incident Report by telephone or fax within the CCL’s next working day and during its normal business hours. Per Assistant Director and Site Supervisor they were not aware of the minimum number of active communicable diseases cases needed to be reported to CCL. Facility did not comply with the reporting requirements regulations. LPA Sanchez reviewed 101212 Reporting Regulations Requirements with Director. Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, the following deficiency is being cited. Director Amy Miller was provided a copy of their appeal rights. This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days. SUPERVISORS NAME: Luisa Gavoutian LICENSING EVALUATOR NAME: Nohemi Sanchez LICENSING EVALUATOR SIGNATURE: DATE: 10/04/2024 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/04/2024 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 2 FACILITY NAME: CAL IVY PREP AT CSUB FACILITY NUMBER: 153810190 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 10/04/2024 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type B 10/18/2024 Section Cited CCR 101212(d) 1 2 3 4 5 6 7101212 Reporting Requirements (d) Upon the occurrence, during the operation of the childcare center of any of the events specified in (d)(1) below, a report shall be made to the Department ...This requirement was not met as evidenced by:1 2 3 4 5 6 7LPA reviewed Reporting Requirements with Licensee and provided a copy. Directed stated they will review 101212 Reporting Requirements regulation and train all Management. Director will submit to the Fresno South Licensing Office a training outline and a sign in sheet by 10/11/2024. 8 9 10 11 12 13 14Based on interviews and records reviewed, Licensee did not comply with the cited regulation, which poses a potential risk to the health, safety, or personal rights to children in care.8 9 10 11 12 13 14 1 2 3 4 5 6 71 2 3 4 5 6 7 1 2 3 4 5 6 71 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:Luisa Gavoutian LICENSING EVALUATOR NAME:Nohemi Sanchez LICENSING EVALUATOR SIGNATURE: DATE: 10/04/2024 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/04/2024

Type B citation - potential risk if not corrected

Based on interviews and records reviewed, Licensee did not comply with the cited regulation, which poses a potential risk to the health, safety, or personal rights to children in care.

Based on a record review and interview, the licensee did not comply with the section cited above. Staff #1, who is present today, is not fingerprint cleared, which poses an immediate health, safety or personal rights risk to persons in care.