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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334843572
Report Date: 03/06/2024
Date Signed: 03/06/2024 04:23:52 PM


Document Has Been Signed on 03/06/2024 04:23 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501



FACILITY NAME:ORTEGA TRAIL YOUTH CENTERS, INCFACILITY NUMBER:
334843572
ADMINISTRATOR:KATHY EVERHARTFACILITY TYPE:
840
ADDRESS:23151 PALOMAR STREETTELEPHONE:
(951) 678-5240
CITY:WILDOMARSTATE: CAZIP CODE:
92595
CAPACITY:30CENSUS: 19DATE:
03/06/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
03:35 PM
MET WITH:Katherine EverhartTIME COMPLETED:
04:35 PM
NARRATIVE
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On March 6, 2024, Licensing Program Analyst (LPA) Cindy Hamilton conducted an unannounced case management visit to Ortega Trail Youth Centers. LPA met with Director, advised the Director of the purpose for the visit, conducted a tour of the facility and took census of staff and students.

During an investigation of Complaint Control # 10-CC-20240222084427, it was reported that on or around February 20, 2024, an incident occurred at the CCC where a child pulled down their pants and underwear exposing their private area and this was witnessed by other children in care. LPA conducted interviews with staff and reviewed records which revealed that the facility did not report the incident(s) to the Department.

In addition, LPA observed the facility is not following the regulations regarding the signing in and out of students. The CCC does not sign-in children with a signature, time and date and there is no evidence of children being signed out.

Based on confidential interviews and records review, the center did not comply with Title 22, and is being cited for the following: Section 101212(d)(1)(C) Reporting Requirements and Section 101229.1(b) Sign In and Sign Out is being cited for non-compliance. The facility is being issued two Type B citations in reference to not reporting the incident(s) and not properly signing children in and out of CCC.

An exit interview was conducted, Director was provided a copy of this report, appeal rights and Notice of Site Visit. Director was reminded that Notice of Site Visit must remain posted for 30 consecutive days.

SUPERVISOR'S NAME: Carlos MartinezTELEPHONE: (951) 782-4950
LICENSING EVALUATOR NAME: Cindy HamiltonTELEPHONE: (951) 295-2190
LICENSING EVALUATOR SIGNATURE:
DATE: 03/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/06/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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Document Has Been Signed on 03/06/2024 04:23 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501


FACILITY NAME: ORTEGA TRAIL YOUTH CENTERS, INC
FACILITY NUMBER: 334843572

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/06/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/19/2024
Section Cited
CCR
101212(d)(1)(C)

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101212(d)(1)(C) Reporting Requirements
(d) Upon the occurrence, during the operation of the child care center...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. (1)Events reported shall include the following: (1) Any unusual incident or child absence that threatens the physical or emotional health or safety of any child. This requirement was not met as evidenced by:
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The facility will conduct training on reporting requirements. The training material and attendance sheet will be submitted to the department on or before POC due date provided in this report. UIR received by CCL 2/29/2024.
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Based on confidential interviews and records review, the CCC did not report the incident involving a child exposing self in front of other children which poses a potential health, safety, and/or personal rights risk to persons in care.
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Type B
03/19/2024
Section Cited
CCR101229

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101229 Sign In and Sign Out (b) The person who brings the child to, and removes the child from, the center shall sign the child in/out. This requirement is not being met as evidenced by:
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The Director has created a sign in and sign out sheet and provided training to all staff. The Director will provide the plan to CCL, the sign-in sheet for the training and a copy of the sign-in and out sheet that will be used for the students on or before the POC due date.
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Based on records review and observation, the CCC is not signing children in and out as required, per Title 22.
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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 MartinezTELEPHONE: (951) 782-4950
LICENSING EVALUATOR NAME: Cindy HamiltonTELEPHONE: (951) 295-2190
LICENSING EVALUATOR SIGNATURE:
DATE: 03/06/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/06/2024
LIC809 (FAS) - (06/04)
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