330909012-9-14-2021-09-CC-AROS-C7Z24N-20211020170410

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 330909012
Report Date: 09/14/2021
Date Signed: 09/14/2021 12:33:31 PM

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 ST., SUITE 700
RIVERSIDE, CA 92501

This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/06/2021 and conducted by Evaluator Elyse Jones

PUBLIC

COMPLAINT CONTROL NUMBER: 09-CC-20210806091902

FACILITY NAME:	CORONA-NORCO FAMILY YMCA		FACILITY NUMBER:	330909012
ADMINISTRATOR:	ART CABRERA		FACILITY TYPE:	840
ADDRESS:	1331 RIVER ROAD		TELEPHONE:	(951) 736-9622
CITY:	CORONA	STATE: CA	ZIP CODE:	92880
CAPACITY:	70	CENSUS: 45	DATE:	09/14/2021
		UNANNOUNCED	TIME BEGAN:	10:31 AM
MET WITH:	Art Cabrera, Director		TIME COMPLETED:	12:45 PM

ALLEGATION(S):

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Staff did not prevent physical altercation between day children resulting in injury

INVESTIGATION FINDINGS:

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On September 14, 2021 Licensing Program Analyst (LPA) Elyse Jones arrived at Corona-Norco Family YMCA to complete and deliver findings for a complaint. LPA conducted a tour of the facility inside & outside.

On August 6, 2021 a complaint was received alleging staff did not prevent physical altercation between day children resulting in injury. It was noted that a child sustained an injury (black eye) while in care at the facility. During interviews it was disclosed that on August 5, 2021 the children were being transported in a YMCA van to a local splash pad for a field trip. During the ride to the splash pad two children who were sitting in the last row of the van were picking on each other, bumping shoulders and elbows. One child asked the other child to stop and then went on to strike the child in the eye which resulted in a black eye. Present on the bus was a Teacher, however, due to the child being in the last row and the Teacher being in the front passenger seat, the Teacher was unable to see the incident occur. It was also disclosed that it was loud in the van. No children informed the staff they were hit or were observed crying. Upon arriving at the splash pad the staff noticed a child had a mark near the eye and offered ice and water. During the investigation the Department

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Aaron Ross	TELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Elyse Jones	TELEPHONE: (951) 897-2468
LICENSING EVALUATOR SIGNATURE:	DATE: 09/14/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2021

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 09-CC-20210806091902

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 ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: CORONA-NORCO FAMILY YMCA	FACILITY NUMBER: 330909012
	VISIT DATE: 09/14/2021

NARRATIVE

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collected documentation but was unable to interview all pertinent parties.

This agency has investigated the complaint alleging staff did not prevent physical altercation between day children resulting in injury. Based on the interviews conducted, the review of pertinent documentation, the allegation is UNSUBSTANTIATED. A finding that the allegation is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the allegation occurred.

No deficiencies cited at this time.

Exit interview was conducted with Art Cabrera. Notice of Site Visit was issued and must be posted for 30 day.
A copy of this report was provided to the facility must be made available to the public for three years upon request.

SUPERVISOR'S NAME: Aaron Ross	TELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Elyse Jones	TELEPHONE: (951) 897-2468
LICENSING EVALUATOR SIGNATURE:	DATE: 09/14/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2021

LIC9099 (FAS) - (06/04)

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