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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 360907186
Report Date: 03/17/2022
Date Signed: 03/17/2022 11:19:03 AM


Document Has Been Signed on 03/17/2022 11:19 AM - 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 ST., SUITE 700
RIVERSIDE, CA 92501



FACILITY NAME:SAN ANDREAS CHILD DEVELOPMENT CENTERFACILITY NUMBER:
360907186
ADMINISTRATOR:ANITA REAFACILITY TYPE:
850
ADDRESS:3232 E. PACIFIC AVENUETELEPHONE:
(909) 862-4063
CITY:HIGHLANDSTATE: CAZIP CODE:
92346
CAPACITY:34CENSUS: DATE:
03/17/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:55 AM
MET WITH:Site Supervisor, Lorena Rodriguez-PetersonTIME COMPLETED:
11:25 AM
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On 03/17/2022, Licensing Program Analysts (LPAs) Destinee Hogue and Laura Mejorado conducted a case management inspection with Site Supervisor, Lorena Rodriguez-Peterson. A case management inspection is being conducted in response to the receipt of an unusual incident report (UIR) received from the facility. The UIR was received by the licensing agency on 12/20/2021. On 01/04/2022, an inspection was conducted by LPA Hogue. During the inspection on 01/04/2022, LPA interviewed staff and children, reviewed facility records, and conducted facility observations. During this inspection, LPAs toured the facility inside and outside, took census of preschool children present on this date, and verified facility associations. The following was discussed with Site Supervisor, Lorena Rodriguez-Peterson.

On an unknown date and time, a staff member reported to Administration that they observed one staff member tugging on a child's hair and another staff member "manhandling" a child (forcing a child to sit down by pulling on child's arm). The date of the above incident(s) is unknown and the names of the involved child(ren) is unknown. LPA Hogue interviewed staff members and there was no disclosure of a staff member tugging or pulling on a child(ren)'s arm or speaking aggressively or "being mean" to children. LPA Hogue interviewed children and there were no reports of staff members pulling on a child(ren)'s hair, pulling or forcing a child(ren) to sit down, or staff members "being mean"/speaking aggressively to child(ren).

On 12/10/2021, Program Specialist Mary Moorer provided staff members a handout on "Dealing with Challenging Behaviors" and a copy of the handout was submitted with UIR. Based on the information obtained, there is not enough information to prove that a child(ren) was mishandled by staff or a child(ren) was spoken to in an aggressive/mean manner. At this time, there appears to be no violations of Title 22 Regulations found. An exit interview was conducted, and a copy of this report was provided to Site Supervisor, Lorena Rodriguez-Peterson. No deficiencies were cited during this inspection and a Notice of Site Visit was issued and shall remain posted for 30 days.
SUPERVISOR'S NAME: Kimberly WilliamsTELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Destinee HogueTELEPHONE: (951) 218-5196
LICENSING EVALUATOR SIGNATURE:
DATE: 03/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/17/2022
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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