334809551-3-22-2021-09-CC-AROS-C38R7E-20210521124612

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 334809551
Report Date: 03/22/2021
Date Signed: 03/22/2021 12:14:31 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
03/19/2021 and conducted by Evaluator Blanca Ruiz-Silva

PUBLIC

COMPLAINT CONTROL NUMBER: 09-CC-20210319155453

FACILITY NAME:	MARTHA'S VILLAGE & KITCHEN		FACILITY NUMBER:	334809551
ADMINISTRATOR:	ROSA VERDUZCO		FACILITY TYPE:	830
ADDRESS:	83-791 DATE AVENUE		TELEPHONE:	(760) 347-4741
CITY:	INDIO	STATE: CA	ZIP CODE:	92201
CAPACITY:	23	CENSUS: 5	DATE:	03/22/2021
		UNANNOUNCED	TIME BEGAN:	11:25 AM
MET WITH:	Maria Beltran Quintero		TIME COMPLETED:	12:00 PM

ALLEGATION(S):

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Daycare child sustained unexplained injury while in care

INVESTIGATION FINDINGS:

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Due to COVID-19 State of Emergency, on 03/22/2021, Licensing Program Analyst (LPA) Blanca Ruiz-Silva conducted a tele-inspection with Director, Maria Beltran Quintero via Google Duo. The purpose of the tele-inspection is to discuss and deliver the findings of the investigation. A 10-day inspection was initiated by LPA Ruiz-Silva on 12/23/2020.
During the initial inspection facility records were requested and obtained for review regarding the above allegation. LPA Ruiz-Silva conducted interviews with pertinent parties present during the incident. LPA gathered the following information: A child arrived at the facility in the morning wearing a mask that covered his/her nose and mouth, an initial visual health check was conducted by staff, it was then noticed that the child had a runny nose (green mucus), dry lips and he/she was biting the lower lip. Staff was also attending to other children in the room who were crying. While the parent/legal guardian of the child was still in the room, staff called facility director to verify if child was approved to be in the classroom due to runny nose.

Please see additional page LIC 9099C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Aaron Ross	TELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Blanca Ruiz-Silva	TELEPHONE: (951) 233-5594
LICENSING EVALUATOR SIGNATURE:	DATE: 03/22/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2021

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-20210319155453

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: MARTHA'S VILLAGE & KITCHEN	FACILITY NUMBER: 334809551
	VISIT DATE: 03/22/2021

NARRATIVE

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Director approved the child to stay. Once approved, child was received and staff proceed to set up classroom for breakfast, since the child had a runny nose staff pulled down child’s mask again to clean his/her nose and observed a red spot on the bottom lip and more mucus coming through the nose. Per staff recollection of events, child continued biting his/her lower lip, since runny nose persisted, staff decided to call the Director to make her aware of the situation. Injury was documented on the health check, and the parent/legal guardian of the child was also notified. No incidents were observed by staff which would have resulted to an injury sustained on child’s lip. When the parent arrived to pick up the child, staff tried to explain the red spot, however, parent became concerned about the issue and emphasize that the child did not have a red spot upon arrival. The Director was notified of the incident and a conversation with parent took place to find a resolution in order to address the parent’s concerns. Incident was also disclosed to licensing the day of occurrence as an unusual incident and an internal investigation was conducted.

Due to the lack of evidence and conflicting statements from pertinent parties; it is unclear if the child sustain an injury to his/her lower lip as a result of having dry lips or due to the child biting his/her lower lip during care. The child was wearing a face covering while in care which obstructed the staff’s view of the child’s lip.

Although the allegation may have happened or is valid, there is no preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is deemed Unsubstantiated at this time.

A Notice of Site Visit was issued on this date. An exit interview was conducted via Google Duo with Maria Beltran Quintero. A copy of this report was emailed to licensee during the Tele-inspection. LPA B.Ruiz provided director with a copy of this report. The electronic “read receipt” of the e-mailed report acknowledges receipt of this report.

THIS REPORT MUST BE AVAILABLE TO THE PUBLIC FOR THREE YEARS.

SUPERVISOR'S NAME: Aaron Ross	TELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Blanca Ruiz-Silva	TELEPHONE: (951) 233-5594
LICENSING EVALUATOR SIGNATURE:	DATE: 03/22/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2021

LIC9099 (FAS) - (06/04)

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