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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334802889
Report Date: 01/28/2020
Date Signed: 01/28/2020 02:40:50 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:OCS OUR LADY OF PERPETUAL HELP PRESCHOOLFACILITY NUMBER:
334802889
ADMINISTRATOR:MARGARITA RIVERAFACILITY TYPE:
850
ADDRESS:82-470 BLISSTELEPHONE:
(760) 347-3786
CITY:INDIOSTATE: CAZIP CODE:
92201
CAPACITY:88CENSUS: 35DATE:
01/28/2020
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:41 PM
MET WITH:Margarita RiveraTIME COMPLETED:
02:48 PM
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Licensing Program Analyst (LPA) Kim Leung conducted a case management inspection at the facility. Unusual incident report (UIR) was received from the facility on 1/15/2020 reporting that Child 1 was terminated by the facility due to the parent's inappropriate behavior. LPA spoke with facility director Margarita Rivera via phone on 1/22/2020 requesting for additional information. Upon arrival this date on 1/28/2020, LPA met with the director and stated the purpose of the inspection. Records were reviewed and interviews were conducted.

LPA obtained information that on 1/14/2020, Child 1's parent came complaining in an aggressive manner about Child 1 being changed into underwear for different gender after having potty accident. It was reported that the parent appeared upset and talked to staff using inappropriate language. LPA obtained information that the incident occurred at the front office which is away from the four activity rooms and the playground. LPA obtained information that when the incident occurred, there were no children present in the front office. LPA obtained information that prior to the incident on 1/7/2020 and 1/9/2020, Child 1 had potty accidents during nap time and the child wet the pants. According to the Parents' Handbook, each enrolled family is required to provide a complete set of extra clothes for the child(ren) in a large zip-loc bag with the child's name labeled. LPA obtained information that the child did have extra clothes stored in the facility, however, it was stored in a different classroom. LPA obtained information that when the child needed to be changed, staff could not locate the extra clothes and staff provided the child with extra clothes belong to the facility. During inspection, LPA observed children's clothes in plastic bags stored in the restroom as well as clothes in plastic bags labeled with children's names stored in individual cubbies. Staff stated that the underpants and sweat pants provided to Child 1 after both potty accidents were clean and for the same gender of the child. Staff denied changing the child into or providing the child with clothes for a different gender. Based on the information received, no deficiency was identified at this time .

Exit interview was conducted with Ms. Rivera and Notice of Site Visit was issued and it must be posted for 30 days. A copy of this report was provided to the facility.
SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Kim LeungTELEPHONE: (951) 529-4713
LICENSING EVALUATOR SIGNATURE:

DATE: 01/28/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2020
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
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