334803229-11-29-2021-09-CC-AROS-CB435M-20220127165659

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 334803229
Report Date: 11/29/2021
Date Signed: 11/29/2021 01:11:08 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
11/19/2021 and conducted by Evaluator Elyse Jones

COMPLAINT CONTROL NUMBER: 09-CC-20211119082227

FACILITY NAME:	RCOE - JEFFFERSON HEADSTART		FACILITY NUMBER:	334803229
ADMINISTRATOR:	MICHELLE AHMAD		FACILITY TYPE:	850
ADDRESS:	1040 S. VICENTIA AVENUE		TELEPHONE:	(951) 826-3234
CITY:	CORONA	STATE: CA	ZIP CODE:	92882
CAPACITY:	37	CENSUS: 23	DATE:	11/29/2021
		UNANNOUNCED	TIME BEGAN:	09:25 AM
MET WITH:	Michelle Ahmad, Director		TIME COMPLETED:	01:16 PM

ALLEGATION(S):

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Personal Rights

INVESTIGATION FINDINGS:

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On November 29, 2021 Licensing Program Analyst (LPA) Elyse Jones arrived at the facility to conduct a 10 day inspection and deliver findings for a complaint. LPA conducted a tour of the facility and took census. During the investigation interviews were conducted with pertinent parties and documentation was collected.

On November 19, 2021 a complaint was received alleging staff are not following COVID-19 masking guidelines. During the facility tour LPA Jones observed all staff and children to be wearing a face covering according to the Center of Disease Control (CDC) and Riverside County Office of Education (RCOE) guidance. LPA also observed postings illustrating how to prevent the spread of COVID-19. During interviews it was disclosed that staff are required to complete a daily self-screening questionnaire which states, staff will follow all safe practices in the workplace which includes "Wearing a face covering over my nose and mouth." and training has been provided to all staff. It was also disclosed that one or more staff are either not wearing a face covering or not wearing a face covering accordning to the CDC and RCOE guidance.

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: 11/29/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/29/2021

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-20211119082227

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: RCOE - JEFFFERSON HEADSTART	FACILITY NUMBER: 334803229
	VISIT DATE: 11/29/2021

NARRATIVE

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Then there were other pertinent parties who disclosed that staff are following the CDC & RCOE guidance. Due to conflicting statements given during interviews and what was observed during the tour, the Department is unable to determine whether the staff are or are not wearing the face coverings and wearing them properly. The Director stated, she will conduct an in-service training to address face coverings. She will also offer one-on-one meetings.

This agency has investigated the complaint. Based on the interviews conducted, the review of pertinent documentation, and conflicting information, 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 and a copy of this report and a Notice of Site Visit was provided to the Director. 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: 11/29/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/29/2021

LIC9099 (FAS) - (06/04)

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