334810126-6-17-2022-10-CC-PBER-CFSQJR-20220627121307

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 334810126
Report Date: 06/17/2022
Date Signed: 06/17/2022 01:51:04 PM

Substantiated

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
03/29/2022 and conducted by Evaluator Anastasia Flores

PUBLIC

COMPLAINT CONTROL NUMBER: 10-CC-20220329091923

FACILITY NAME:	DESERT YMCA/AMELIA EARHARDT CHILD CARE CENTER		FACILITY NUMBER:	334810126
ADMINISTRATOR:	JUSTIN HICKEY		FACILITY TYPE:	840
ADDRESS:	45-250 DUNE PALM ROAD		TELEPHONE:	(760) 771-1811
CITY:	INDIO	STATE: CA	ZIP CODE:	92201
CAPACITY:	80	CENSUS: 80	DATE:	06/17/2022
		UNANNOUNCED	TIME BEGAN:	01:27 PM
MET WITH:	Justin Hickey		TIME COMPLETED:	01:59 PM

ALLEGATION(S):

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Incidents are not being reported.

INVESTIGATION FINDINGS:

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On June 17, 2022 at xx PM, Licensing Program Analyst (LPA) Anastasia Flores arrived to the YMCA main office and greeted by Site Director, Justin Hickey to deliver the findings on the above allegation. On April 6, 2022 at 12:25 PM, LPA conducted a health and safety inspection and no immediate concerns were noted. Copies of staff roster, staff trainings, and LPA reviewed children’s fils.. Interviews were conducted with staff #1, #2, #3.
On March 29, 2022 this agency received allegation the facility is not reporting incidents with children in care to the licensing agency. It was reported that on at least two separate occasions, the facility failed to notify a parent of serious emotional or physical concerns while child #1 (C1) was in care. Confidential interviews revealed that the CEO stated the facility has, “glow notes,” which satisfies the minimum licensing requirements. Interview with S1 disclosed the facility gives ouch reports to the parents to sign and then document it on a log. Interview with S3 disclosed that the incidents were not reported to licensing as he was not aware it was supposed to occur.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Pauline Beschorner	TELEPHONE: (951) 782-6641
LICENSING EVALUATOR NAME: Anastasia Flores	TELEPHONE: (951) 533-2031
LICENSING EVALUATOR SIGNATURE:	DATE: 06/17/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2022

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 10-CC-20220329091923

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: DESERT YMCA/AMELIA EARHARDT CHILD CARE CENTER	FACILITY NUMBER: 334810126
	VISIT DATE: 06/17/2022

NARRATIVE

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Based on confidential interviews and record review, the preponderance of evidence standard has been met, therefore. the above allegation the facility is not reporting incidents in regard to children in care, is substantiated. The facility is being cited for, Title 22, division 12, chapter 1, article 06, continuing requirements; section 101212(d)(1)(D) Reporting requirements, the facility did not report incidents that occurred with Child #1 on at least one or more occasion. This poses a potential risk to children in care.
An exit interview was conducted, A copy of this report, 9099D (deficiency page), LIC811 (confidential names) appeal rights and Notice of Site Visit were provided to Justin Hickey on 06/17/22.

The facility representative was informed that the “Notice of Site Visit” must be posted for 30 consecutive days. Failure to post will result in Civil Penalties of $100.00. The “Notice of Site Visit” must be posted on or adjacent to the door.

SUPERVISOR'S NAME: Pauline Beschorner	TELEPHONE: (951) 782-6641
LICENSING EVALUATOR NAME: Anastasia Flores	TELEPHONE: (951) 533-2031
LICENSING EVALUATOR SIGNATURE:	DATE: 06/17/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2022

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 10-CC-20220329091923

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: DESERT YMCA/AMELIA EARHARDT CHILD CARE CENTER	FACILITY NUMBER: 334810126
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/17/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 06/24/2022 Section Cited CCR 101212(d)(1)(D)	1 2 3 4 5 6 7	101212(d)(1)(D) Reporting requirements, Upon the occurrence, during the operation of the child care center of any of the events specified in (d)(1) below, a report shall be made to the Department by telephone or fax within the Department's next working day and during its normal business hours. in addition, a written report containing the information specified in (d)(2) below shall be submitted to the Department within seven days following the occurrence of such event. Events reported shall include the following: Any suspected physical or psychological abuse of any child.	1 2 3 4 5 6 7	LPA Flores will receive a plan of corrections letter from Justin Hickey via email by 06/24/22.
	8 9 10 11 12 13 14	Based on the facility did not report incidents that occurred with Child #1 on at least one or more occasion. This poses a potential risk to children in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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: Pauline Beschorner	TELEPHONE: (951) 782-6641
LICENSING EVALUATOR NAME: Anastasia Flores	TELEPHONE: (951) 533-2031
LICENSING EVALUATOR SIGNATURE:	DATE: 06/17/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2022

LIC9099 (FAS) - (06/04)

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