334812555-8-16-2023-10-CC-CMAZ-CVFNKB-20230907103138

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 334812555
Report Date: 08/16/2023
Date Signed: 08/16/2023 01:43:10 PM

Unsubstantiated

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
07/12/2023 and conducted by Evaluator Sumayya Habeebulla

COMPLAINT CONTROL NUMBER: 10-CC-20230712122253

FACILITY NAME:	FSA-MORENO VALLEY CDC		FACILITY NUMBER:	334812555
ADMINISTRATOR:	SHARMALEE SAMUEL		FACILITY TYPE:	830
ADDRESS:	21250 BOX SPRINGS RD #115		TELEPHONE:	(951) 779-9784
CITY:	MORENO VALLEY	STATE: CA	ZIP CODE:	92557
CAPACITY:	36	CENSUS: 18	DATE:	08/16/2023
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Sharmalee Samuel		TIME COMPLETED:	02:00 PM

ALLEGATION(S):

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- Facility a/c is in disrepair

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Sumayya Habeebulla arrived at the facility for the purpose of conducting a subsequent complaint visit, which includes concluding the investigation and delivering the investigation findings regarding the compliant investigation initiated on 07/12/23. LPA met with Director Sharmalee Samuel and discussed the above allegations.

On 07/18/23 LPA Habeebulla conducted interviews with 3 staff members and obtained information to interview 2 additional staff and interviewed them on a later date. Along with the interviews, the investigation revealed that:

See LIC 9099C for continuation.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Carlos Martinez	TELEPHONE: (951) 782-4950
LICENSING EVALUATOR NAME: Sumayya Habeebulla	TELEPHONE: 951-201-1991
LICENSING EVALUATOR SIGNATURE:	DATE: 08/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2023

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 5

Control Number 10-CC-20230712122253

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: FSA-MORENO VALLEY CDC	FACILITY NUMBER: 334812555
	VISIT DATE: 08/16/2023

NARRATIVE

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There is an allegation that Facility a/c is in disrepair. On 07/18/23 during the visit LPA recorded the thermostat reading in the Toddler classroom as 82 degrees Fahrenheit and the outside temperature as 93 degrees Fahrenheit. There were no children present in the classroom, but LPA observed 2 air coolers and one fan (mounted on the wall) functioning in the classroom. The students of the Toddler room were shifted to the infant room due to the air conditioning malfunction in the toddler classroom. Interviews revealed that the air conditioner began to give problems in the afternoon of Wednesday 07/12/23. On Thursday it was functioning off and on properly and the facility maintenance was notified. The air conditioner began to function properly and again gave problems on Friday afternoon. Parents were notified of the situation.

From the information received by interviews with staff, and facility documents the above allegation cannot be verified. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the allegation did or did not occur, therefore, the allegation is UNSUBSTANTIATED.

An exit interview was conducted, a Notice of Site Visit posted, and a copy of this report was provided to the facility on this date and time.

SUPERVISOR'S NAME: Carlos Martinez	TELEPHONE: (951) 782-4950
LICENSING EVALUATOR NAME: Sumayya Habeebulla	TELEPHONE: 951-201-1991
LICENSING EVALUATOR SIGNATURE:	DATE: 08/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 5

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
07/12/2023 and conducted by Evaluator Sumayya Habeebulla

COMPLAINT CONTROL NUMBER: 10-CC-20230712122253

FACILITY NAME:	FSA-MORENO VALLEY CDC		FACILITY NUMBER:	334812555
ADMINISTRATOR:	SHARMALEE SAMUEL		FACILITY TYPE:	830
ADDRESS:	21250 BOX SPRINGS RD #115		TELEPHONE:	(951) 779-9784
CITY:	MORENO VALLEY	STATE: CA	ZIP CODE:	92557
CAPACITY:	36	CENSUS: 18	DATE:	08/16/2023
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Sharmalee Samuel		TIME COMPLETED:	02:00 PM

ALLEGATION(S):

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- Staff are not providing a comfortable envirnoment for day care children

INVESTIGATION FINDINGS:

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Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Carlos Martinez	TELEPHONE: (951) 782-4950
LICENSING EVALUATOR NAME: Sumayya Habeebulla	TELEPHONE: 951-201-1991
LICENSING EVALUATOR SIGNATURE:	DATE: 08/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 3 of 5

Control Number 10-CC-20230712122253

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: FSA-MORENO VALLEY CDC	FACILITY NUMBER: 334812555
	VISIT DATE: 08/16/2023

NARRATIVE

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The second allegation is staff are not providing a comfortable environment for day care children. The interviews revealed that due to the air conditioner not functioning properly on 07/12/23, 07/13/23, and 07/14/23, some children were fussy and restless in the classroom. Interviews conducted were unable to establish a date or time when the additional air coolers and fan were brought into the classroom. The week of July 10th was recorded as a heat wave and due to the fact of the air conditioning not functioning properly and the indoor temperature being in the eighties while the outdoor temperature was in the high nineties makes the classroom uncomfortable for the toddlers in care.

Based on LPAs observations and interviews which were conducted and record review, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, (Title 22, 101239 Fixtures, Furniture, Equipment and Supplies), are being cited on the attached LIC 9099D.

An exit interview was conducted with director Sharmalee Samuel, a Notice of Site Visit posted, and a copy of this report was provided to the facility on this date and time.

SUPERVISOR'S NAME: Carlos Martinez	TELEPHONE: (951) 782-4950
LICENSING EVALUATOR NAME: Sumayya Habeebulla	TELEPHONE: 951-201-1991
LICENSING EVALUATOR SIGNATURE:	DATE: 08/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2023

LIC9099 (FAS) - (06/04)

Page: 4 of 5

Control Number 10-CC-20230712122253

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: FSA-MORENO VALLEY CDC	FACILITY NUMBER: 334812555
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/16/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 08/29/2023 Section Cited CCR 101239(a)	1 2 3 4 5 6 7	(a) A comfortable temperature for children shall be maintained at all times. Based on interview and record review, facility failed to ensure a comfortable temperature for the children during the heat wave which poses a potential health, safety or personal rights risk to persons in care.	1 2 3 4 5 6 7	Facility representative agrees to create a plan to ensure to maintain a comfortable temperature for the children in care if an air conditioner malfunctions. Facility representative will submit the plan to the department by the POC due date.
	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
	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: Carlos Martinez	TELEPHONE: (951) 782-4950
LICENSING EVALUATOR NAME: Sumayya Habeebulla	TELEPHONE: 951-201-1991
LICENSING EVALUATOR SIGNATURE:	DATE: 08/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2023

LIC9099 (FAS) - (06/04)

Page: 5 of 5