334820096-4-24-2024-09-CC-GSEA-D52L78-20240507082953

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 334820096
Report Date: 04/24/2024
Date Signed: 04/24/2024 05:05:00 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 ST., SUITE 700
RIVERSIDE, CA 92501

This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/25/2024 and conducted by Evaluator Giselle Carbullido

PUBLIC

COMPLAINT CONTROL NUMBER: 09-CC-20240325125500

FACILITY NAME:	MELODY LANE CHILDREN'S CENTER		FACILITY NUMBER:	334820096
ADMINISTRATOR:	JULIE BACA		FACILITY TYPE:	840
ADDRESS:	9191 COLORADO AVENUE		TELEPHONE:	(951) 352-2161
CITY:	RIVERSIDE	STATE: CA	ZIP CODE:	92503
CAPACITY:	17	CENSUS: 13	DATE:	04/24/2024
		UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Julie Baca and Janice Randolph		TIME COMPLETED:	05:00 PM

ALLEGATION(S):

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Staff hit daycare children
Staff did not prevent child from being bullied.

INVESTIGATION FINDINGS:

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On the date and time listed above, Licensing Program Analyst (LPA) Giselle Carbullido arrived at the facility to investigate the above complaint received on 03/25/24. An initial visit was conducted on 03/28/24 at which time LPA conducted interviews and reviewed records. LPA was given access to the facility by the Director, Julie Baca and Licensee, Janice Randolph. LPA discussed purpose of visit, took census; toured the facility and conducted additional interviews. LPA met with the Director and Licensee to further discuss the complaint allegations and deliver findings.
It was alleged staff hit children and did not prevent a child from being bullied. During the investigation, LPA interviewed all pertinent parties, including facility staff and day care children.
Pertinent party interviews reported an incident occurred in the classroom in which a staff pushed/hit a child on their back resulting in the child hitting back in defense. Interviews revealed the staff gave instructions to ‘get the child’ resulting in the child being tackled by other children to the ground. Interviews also reported the child was crying during the incident and the staff did nothing to stop the situation.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Gilbert Sena	TELEPHONE: (951) 782-4844
LICENSING EVALUATOR NAME: Giselle Carbullido	TELEPHONE: (951) 970-1904
LICENSING EVALUATOR SIGNATURE:	DATE: 04/24/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2024

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-20240325125500

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: MELODY LANE CHILDREN'S CENTER	FACILITY NUMBER: 334820096
	VISIT DATE: 04/24/2024

NARRATIVE

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LPA reviewed the following records: Screen shots of phone texts. Record review revealed parent reached out to notify the facility staff about the incident via phone text.
Based on interviews conducted and documents reviewed, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED per California Code of Regulations, Title 22, Division 12. See LIC9099D for cited deficiency
LPA Carbullido informed facility representatives Julie Baca and Janice Randolph that this report dated 04/24/24 document(s) (1) Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.
Also, LPA Carbullido informed the licensee to provide a copy of this licensing report dated 04/24/24 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.
Appeal rights issued and discussed with licensee and their signature on this form acknowledges receipt of these rights. An exit interview was conducted, a copy of this report and Notice of Site Visit were provided to the Director, Julie Baca and Licensee, Janice Randolph. THIS REPORT DOES HAVE TO BE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.

SUPERVISOR'S NAME: Gilbert Sena	TELEPHONE: (951) 782-4844
LICENSING EVALUATOR NAME: Giselle Carbullido	TELEPHONE: (951) 970-1904
LICENSING EVALUATOR SIGNATURE:	DATE: 04/24/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2024

LIC9099 (FAS) - (06/04)

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Control Number 09-CC-20240325125500

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: MELODY LANE CHILDREN'S CENTER	FACILITY NUMBER: 334820096
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/24/2024

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 04/25/2024 Section Cited CCR 101223(a)(3)	1 2 3 4 5 6 7	Personal Rights 101223(a)(3) To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse or other actions of a punitive nature ... aids to physical functioning. This requirement is not met as evidenced by:	1 2 3 4 5 6 7	Facility will submit a written plan for following up on incidents regarding child/staff interactions including a statement of understanding for CCR 101223(a)(3) regulation by POC due date 04/25/24.
	8 9 10 11 12 13 14	Based on interviews conducted the licensee did not comply with the section cited above in that a staff directed other children to tackle a child (encouraged actions of a punitive nature) resullting in a child crying which posed an immediate health, safety or personal rights risk to persons in care.	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: Gilbert Sena	TELEPHONE: (951) 782-4844
LICENSING EVALUATOR NAME: Giselle Carbullido	TELEPHONE: (951) 970-1904
LICENSING EVALUATOR SIGNATURE:	DATE: 04/24/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2024

LIC9099 (FAS) - (06/04)

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