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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 334805395
Report Date: 01/21/2020
Date Signed: 01/21/2020 11:10:42 AM



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
01/14/2020 and conducted by Evaluator Lakesha Edwards
COMPLAINT CONTROL NUMBER: 10-CC-20200114154745
FACILITY NAME:ARMADA ELEMENTARY HEAD STARTFACILITY NUMBER:
334805395
ADMINISTRATOR:DARLENE MINJAREZFACILITY TYPE:
850
ADDRESS:25201 JOHN F KENNEDY DRIVETELEPHONE:
(951) 485-5886
CITY:MORENO VALLEYSTATE: CAZIP CODE:
92551
CAPACITY:119CENSUS: 99DATE:
01/21/2020
UNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Oxana Ackerson-Education CoordinatorTIME COMPLETED:
11:10 AM
ALLEGATION(S):
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Absence of Supervision
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA), La Kesha Edwards met with Oxana Ackerson, Education Coordinator to issue the complaint findings for the above listed allegation. LPA conducted a safety inspection of the facility on January 13, 2020 and again on January 21, 2020 and reviewed staff’s and children’s files.

During the investigation, interviews were conducted with staff and parents by phone and the child. The facility reported an Unusual Incident on January 13, 2020, however a complaint was also received by another party on January 14, 2020.

The complaint alleged that on January 13, 2020, a male child was walking unsupervised in the parking lot and was almost hit by a car before trying to run into the street. In the Unusual Incident Report that the facility reported, the facility stated the child was observed by a parent to be in the parking lot and was brought to the preschool office by the parent.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Dawn ParkerTELEPHONE: (951) 320-2101
LICENSING EVALUATOR NAME: Lakesha EdwardsTELEPHONE: (951) 970-4412
LICENSING EVALUATOR SIGNATURE:

DATE: 01/21/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2020
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 3
Control Number 10-CC-20200114154745
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: ARMADA ELEMENTARY HEAD START
FACILITY NUMBER: 334805395
VISIT DATE: 01/21/2020
NARRATIVE
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The facility staff failed to meet the responsibility for providing care and supervision that was necessary to meet the needs for the child. Staff did not notice the child was missing from the playground for an unknown amount of time until a parent almost hit the child in the parking lot and another parent returned to the gate of the head start playground to ask staff if a child was missing.

Based on interviews conducted and the information gathered, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. See the next page for deficiency cited.

Report is being AMENDED to remove Civil Penalty. Facility is exempt from Civil Penalty.

A NOTICE OF SITE VISIT WAS ISSUED AND LPA VERIFIED THAT IT WAS POSTED IN A PROMINENT LOCATION AT THE FACILITY BEFORE LEAVING. THE LICENSEE UNDERSTANDS THAT IT MUST REMAIN POSTED FOR THE NEXT 30 DAYS ALONG WITH A COPY OF ALL TYPE A DEFICIENCIES (LIC809D/9099D) CITED DURING THIS INSPECTION. A COPY OF ALL TYPE A DEFICIENCIES CITED DURING THIS INSPECTION MUST ALSO BE IMMEDIATELY (within 24 hours of the child’s next day in care) GIVEN TO THE PARENTS OF ALL CHILDREN ENROLLED IN THE CHILD CARE FACILITY AND ANY CHILDREN ENROLLED INTO THE CHILD CARE FACILITY OVER THE NEXT 12 MONTHS.

An exit interview was conducted, and a copy of this report was provided to Oxana Ackerson, Site Education Coordinator.
SUPERVISOR'S NAME: Dawn ParkerTELEPHONE: (951) 320-2101
LICENSING EVALUATOR NAME: Lakesha EdwardsTELEPHONE: (951) 970-4412
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
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 10-CC-20200114154745
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: ARMADA ELEMENTARY HEAD START
FACILITY NUMBER: 334805395
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/21/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
01/22/2020
Section Cited
CCR
101229(a)(1)
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Responsibility for Providing Care and Supervision. The licensee shall provide care and supervision as necessary to meet the children's needs. No children shall be left without the supervision of a teacher at any time except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation.
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Director to retrain staff on the Responsibility for Providing Care and Supervision and a written statement of understanding/compliance along with signatures of this training is to be provided to the LPA by due date of 01/22/2020.
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This requirement was not met as evidenced by:
Child was able to get out of the playground area and walk into the parking lot unsupervised by staff. This poses an immediate risk to the Health and Safety of children in care.
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Report Amended to remove Civil Penalty
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Dawn ParkerTELEPHONE: (951) 320-2101
LICENSING EVALUATOR NAME: Lakesha EdwardsTELEPHONE: (951) 970-4412
LICENSING EVALUATOR SIGNATURE:

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

DATE: 01/28/2020
LIC9099 (FAS) - (06/04)
Page: 3 of 3