330901543-11-14-2024-10-CC-CMAZ-DB9VYP-20241122155126

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 330901543
Report Date: 11/14/2024
Date Signed: 11/14/2024 04:09:27 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/19/2024 and conducted by Evaluator Cindy Hamilton

PUBLIC

COMPLAINT CONTROL NUMBER: 10-CC-20240919152325

FACILITY NAME:	ANNE SULLIVAN PRESCHOOL AND KINDERGARTEN		FACILITY NUMBER:	330901543
ADMINISTRATOR:	ALICIA BEATRIZ VAL		FACILITY TYPE:	850
ADDRESS:	21776 PALOMAR ST.		TELEPHONE:	(951) 678-3557
CITY:	WILDOMAR	STATE: CA	ZIP CODE:	92595
CAPACITY:	116	CENSUS: 61	DATE:	11/14/2024
		UNANNOUNCED	TIME BEGAN:	03:45 PM
MET WITH:	Alicia Vai		TIME COMPLETED:	04:20 PM

ALLEGATION(S):

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Staff did not provide adequate supervision to a daycare child.

INVESTIGATION FINDINGS:

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On November 14, 2024, at 3:45 pm, Licensing Program Analyst (LPA) Cindy Hamilton and Licensing Program Manager (LPM) Carlos Martinez met with Director Alicia Vai to deliver the findings for the above allegation. On September 26, 2024, LPA conducted health and safety inspections of the facility, and no immediate health and/or safety concerns were noted. During the investigation, LPA conducted interviews with four staff, three children, and one parent. LPA also obtained copies of pertinent documentation from facility and children’s files. The child identified as the victim and/or witness was not interviewed because LPA did not have parent approval.

On September 19, 2024, Community Care Licensing (CCL) received information stating staff did not provide adequate supervision to a daycare child. It was alleged that a child was left in a separate room alone without supervision. Confidential interviews revealed that the child was having a difficult time at drop-off. LPA observed the classroom camera footage and observed the child follow a teacher into the quiet room, door was open and child was able to go in and out of the room.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Carlos Martinez	TELEPHONE: (951) 782-4950
LICENSING EVALUATOR NAME: Cindy Hamilton	TELEPHONE: (951) 295-2190
LICENSING EVALUATOR SIGNATURE:	DATE: 11/14/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/14/2024

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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Control Number 10-CC-20240919152325

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: ANNE SULLIVAN PRESCHOOL AND KINDERGARTEN	FACILITY NUMBER: 330901543
	VISIT DATE: 11/14/2024

NARRATIVE

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Additionally, the teacher and other children were also in and out of the room. At no time was the child made to stay in the room and there was still always supervision of two teachers in the classroom. LPA also observed the child voluntarily leave and return to the room multiple times. The camera footage also revealed that additional staff was called to the classroom for assistance and that staff was in the quiet room talking with the two children until the children were ready to join circle time with the rest of the class.

Based on interviews, observation and records review, the allegation Staff did not provide adequate supervision to a daycare child, may have occurred, however is not supported or proven by evidence. Therefore, the allegation is unsubstantiated at this time.

A copy of this report, appeal rights and Notice of Site Visit were provided to director. The director was reminded that the Notice of Site Visit must be posted for 30 days and was posted prior to LPA leaving the CCC.

SUPERVISOR'S NAME: Carlos Martinez	TELEPHONE: (951) 782-4950
LICENSING EVALUATOR NAME: Cindy Hamilton	TELEPHONE: (951) 295-2190
LICENSING EVALUATOR SIGNATURE:	DATE: 11/14/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/14/2024

LIC9099 (FAS) - (06/04)

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