334841935-4-17-2023-09-CC-AROS-CRNHGR-20230509061134

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 334841935
Report Date: 04/17/2023
Date Signed: 04/17/2023 12:28:26 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 ST., SUITE 700
RIVERSIDE, CA 92501

This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/01/2023 and conducted by Evaluator Karrene Turner

COMPLAINT CONTROL NUMBER: 09-CC-20230201131649

FACILITY NAME:	FSA-RUBIDOUX CDC		FACILITY NUMBER:	334841935
ADMINISTRATOR:	CASTRO, GRACIELA		FACILITY TYPE:	830
ADDRESS:	3865 RIVERVIEW DRIVE		TELEPHONE:	(951) 680-0312
CITY:	JURUPA VALLEY	STATE: CA	ZIP CODE:	92509
CAPACITY:	24	CENSUS: 10	DATE:	04/17/2023
		UNANNOUNCED	TIME BEGAN:	11:28 AM
MET WITH:	Alondra Rios-Dominguez, Director		TIME COMPLETED:	12:30 PM

ALLEGATION(S):

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Personal Rights - Day care child sustained injuries while in care
Reporting Requirements - Facility staff are not following reporting requirements

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPAs) Kay Turner and Raymond Moorehead Jr arrived at the facility to provide investigation findings of the above allegations. LPA Turner met with the Director, Alondra Rios-Dominguez, and stated the purpose of today’s inspection. The facility was toured and a census was taken. During the initial inspection on 02/01/2023, LPA Turner interviewed pertinent parties and obtained relevant documents related to the investigation.

The allegations alleged that a day care child sustained injuries while in care and facility staff are not following reporting requirements. The complaint stated a day care child was hurt while in care at the facility and the authorized representative was not provided proper noticing and/or explanation regarding the injuries. It was alleged a day care child sustained a bruise and a scratch on two separate occassions; of which neither instance was reported to the authrorized representative.

Information obtained during the course of the investigation could not determine a daycare child sustained

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Karrene Turner
LICENSING EVALUATOR SIGNATURE:	DATE: 04/17/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2023

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-20230201131649

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: FSA-RUBIDOUX CDC	FACILITY NUMBER: 334841935
	VISIT DATE: 04/17/2023

NARRATIVE

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injuries while in the care of the facility. According to the Family Service Association Family Handbook, “Upon greeting the child and parent each morning, an educator will conduct a brief health check in the presence of the parent/guardian before the parent/guardian leaves the Center. This check is completed by a staff member in the child’s classroom.” Prior to being accepted by the facility, the teacher completes a body check of the child and injuries are notated on the daily attendance and health inspection sheet. LPA obtained and thoroughly reviewed the daily attendance and health inspection sheets from 11/28/2022 to 02/10/2023. The sheets notate marks, bruising, health condition and/or diaper rash of all children left in the care of the facility, including the specified child during the disclosed time frame. While the handbook does not discuss ouch reports, LPA determined via staff interviews ouch reports are completed if injuries are sustained at the facility.

Based on the interviews conducted, the review of the pertinent documentation and conflicting information, the allegation is UNSUBSTANTIATED. A finding that the allegation is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the allegation occurred.

No deficiencies were found at this time.

Exit interview was conducted with the Director, Alondra Rios-Dominguez. A copy of this report was provided. A Notice of Site Visit was given and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. A copy of this report must be made available to the public for three years upon request.

SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Karrene Turner
LICENSING EVALUATOR SIGNATURE:	DATE: 04/17/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2023

LIC9099 (FAS) - (06/04)

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