334818026-12-9-2022-10-CC-CMAZ-CN32V4-20230113164315

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 334818026
Report Date: 12/09/2022
Date Signed: 12/09/2022 09:00:16 AM

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
11/01/2022 and conducted by Evaluator James Wilkerson

PUBLIC

COMPLAINT CONTROL NUMBER: 10-CC-20221101145021

FACILITY NAME:	KIDS COLLABORATE EARLY LEARNING CENTER, INC.		FACILITY NUMBER:	334818026
ADMINISTRATOR:	KELLY HERNANDEZ		FACILITY TYPE:	850
ADDRESS:	36555 VAN GAALE LANE		TELEPHONE:	(951) 926-1600
CITY:	WINCHESTER	STATE: CA	ZIP CODE:	92596
CAPACITY:	144	CENSUS: 11	DATE:	12/09/2022
		UNANNOUNCED	TIME BEGAN:	07:00 AM
MET WITH:	Suriati Cafaro		TIME COMPLETED:	09:15 AM

ALLEGATION(S):

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Facility staff did not provide food service as agreed

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) James Wilkerson arrived at this facility to conclude an investigation into the above allegation. LPA initiated the investigation with a visit conducted on 11/08/22 and extended it at that time. LPA toured the facility and conducted census on this date (12/09/22). It was alleged that facility representative(s) promised parents that the facility would start providing lunch for the children enrolled.beginning as early as 09/06/22, During the course of this investigation interviews were conducted with a random sampling of parents who have children enrolled in this facility. Ms. Cafaro stated on 11/08/22 to LPA "we were planning on providing meals since the change of ownership, however, the Fairview fire and shortages of shipments have caused a delay. Parent's were notified to keep supplying lunch as they were prior to the change of ownership until the shipments can be made. We promised the parents meals would be served once we get the necessary supplies. I tell them we are looking at a certain date, but it is not guaranteed". Information received from interviews with parents disclosed that they were promised that the lunches woud begin being served, but the facility had not started this service as of 11/08/22.
SEE NEXT PAGE

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Carlos Martinez	TELEPHONE: (951) 782-4950
LICENSING EVALUATOR NAME: James Wilkerson	TELEPHONE: (951) 218-7031
LICENSING EVALUATOR SIGNATURE:	DATE: 12/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2022

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

Citations on this Visit Report are Under Appeal!

Control Number 10-CC-20221101145021

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: KIDS COLLABORATE EARLY LEARNING CENTER, INC.	FACILITY NUMBER: 334818026
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 12/09/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Under Appeal Type B 12/30/2022 Section Cited CCR 101219(a)(7)	1 2 3 4 5 6 7	Admission Policies - (a) Every child care center shall have all admission policies in writing and available to the public. The policies shall coincide with the limitations stated on the license, and shall include, but not be limited to, the following: (7) Food-service provisions. This requirement was not met as evidenced by: Parent's	1 2 3 4 5 6 7	Director, Suriati Cafaro stated that the facility will begin serving lunches on Monday, 12/12/22 and agrees to submit this information to LPA in writing by 12/30/22. Ms. Cafaro provided a menu starting on 12/12/22 during today's visit.
	8 9 10 11 12 13 14	were promised that lunches would start being provided as early as 09/06/22 and this service hadn't began as of 11/08/22. This service is not in writing, but was implied verbally.	8 9 10 11 12 13 14
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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: Carlos Martinez	TELEPHONE: (951) 782-4950
LICENSING EVALUATOR NAME: James Wilkerson	TELEPHONE: (951) 218-7031
LICENSING EVALUATOR SIGNATURE:	DATE: 12/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2022

LIC9099 (FAS) - (06/04)

Page: 4 of 5

Control Number 10-CC-20221101145021

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: KIDS COLLABORATE EARLY LEARNING CENTER, INC.	FACILITY NUMBER: 334818026
	VISIT DATE: 12/09/2022

NARRATIVE

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The preponderance of evidence has been met from the information received from parents who were interviewed and will substantiate the allegation of "Facility staff did not provide food service as agreed ".

While providing lunch was in not in writing in any Admission's Policy, it was promised to begin , however was not provided due to circumstances beyond staff's control because of shipping problems and the Fairview Fire.

SEE LIC 9099D for deficiency cited.

An exit interview was conducted, A Notice of Site Visit posted, appeal rights discussed and provided along with a copy of this report on this date to Ms. Cafaro.

SUPERVISOR'S NAME: Carlos Martinez	TELEPHONE: (951) 782-4950
LICENSING EVALUATOR NAME: James Wilkerson	TELEPHONE: (951) 218-7031
LICENSING EVALUATOR SIGNATURE:	DATE: 12/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2022

LIC9099 (FAS) - (06/04)

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