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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 330907996
Report Date: 09/13/2022
Date Signed: 09/13/2022 12:02:31 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
08/11/2022 and conducted by Evaluator Sumayya Habeebulla
PUBLIC
COMPLAINT CONTROL NUMBER: 10-CC-20220811115419
FACILITY NAME:SHEPHERD OF THE VALLEY CHILD CARE CENTERFACILITY NUMBER:
330907996
ADMINISTRATOR:LINDA WILLIAMSONFACILITY TYPE:
850
ADDRESS:11650 PERRIS BOULEVARDTELEPHONE:
(951) 924-3422
CITY:MORENO VALLEYSTATE: CAZIP CODE:
92557
CAPACITY:72CENSUS: 26DATE:
09/13/2022
UNANNOUNCEDTIME BEGAN:
11:04 AM
MET WITH:Linda WilliamsonTIME COMPLETED:
12:20 PM
ALLEGATION(S):
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- Staff handled child in a physically inappropriate manner
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Sumayya Habeebulla arrived at the facility for the purpose of conducting a subsequent complaint visit, which includes concluding the investigation and delivering the investigation findings regarding the compliant investigation initiated on 08/16/22. LPA met with Director Linda Williamson and discussed the above allegation.

On 08/16/22 LPA Habeebulla conducted interviews with 4 staff members, including 5 children and the program director, all of whom are pertinent to this investigation. Along with interviews, the investigation revealed that:
There is an allegation that the staff handled a child in a physically inappropriate manner. Based on the information obtained and pertinent interviews conducted with staff and children, LPA was unable to corroborate allegation as there were no eyewitnesses to the incident and was unable to gather any physical evidence.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Carlos MartinezTELEPHONE: (951) 782-4950
LICENSING EVALUATOR NAME: Sumayya HabeebullaTELEPHONE: 951-201-1991
LICENSING EVALUATOR SIGNATURE:

DATE: 09/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2022
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 2
Control Number 10-CC-20220811115419
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: SHEPHERD OF THE VALLEY CHILD CARE CENTER
FACILITY NUMBER: 330907996
VISIT DATE: 09/13/2022
NARRATIVE
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 In addition, after speaking with all pertinent parties, LPA was unable to obtain further details of the incident, including names and/or details of the date it occurred.

LPA Habeebulla concluded that there was not enough corroborating evidence obtained during the investigation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the allegation did or did not occur, therefore the allegation is UNSUBSTANTIATED

An exit interview was conducted, a Notice of Site Visit posted, and a copy of this report was provided to the facility on this date and time.
SUPERVISOR'S NAME: Carlos MartinezTELEPHONE: (951) 782-4950
LICENSING EVALUATOR NAME: Sumayya HabeebullaTELEPHONE: 951-201-1991
LICENSING EVALUATOR SIGNATURE:

DATE: 09/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2