360910037-12-9-2021-09-CC-GSEA-C9NM5W-20211213081858

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 360910037
Report Date: 12/09/2021
Date Signed: 12/09/2021 12:40:00 PM

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
08/04/2021 and conducted by Evaluator Patricia Berry

PUBLIC

COMPLAINT CONTROL NUMBER: 09-CC-20210804105944

FACILITY NAME:	REDEEMER LUTHERAN PRESCHOOL		FACILITY NUMBER:	360910037
ADMINISTRATOR:	MONICA OSORIO		FACILITY TYPE:	850
ADDRESS:	920 W. 6TH STREET		TELEPHONE:	(909) 986-2615
CITY:	ONTARIO	STATE: CA	ZIP CODE:	91762
CAPACITY:	51	CENSUS: 33	DATE:	12/09/2021
		UNANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Monica Osorio/Director		TIME COMPLETED:	01:13 PM

ALLEGATION(S):

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Staff dislocated child's elbow
Staff handle children in a rough manner

INVESTIGATION FINDINGS:

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On 12/9/21 at 12:00 pm, Licensing Program Analyst Patricia Berry conducted a subsequent complaint investigation to deliver final findings. LPA was granted access into the facility. LPA met with director, toured facility and took a census.

Staff dislocated child's elbow/Staff handle children in a rough manner
On 8/04/21, it was alleged a daycare child sustained a dislocated elbow when staff grabbed their arm. Investigator Charlotte Jackson, from the Department’s Investigation Branch, conducted the investigation. During the investigation, all pertinent parties were interviewed, and documentation was obtained

(Cont. on 9099C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Gilbert Sena	TELEPHONE: (951) 782-4844
LICENSING EVALUATOR NAME: Patricia Berry	TELEPHONE: (951) 782-4952
LICENSING EVALUATOR SIGNATURE:	DATE: 12/09/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2021

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-20210804105944

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: REDEEMER LUTHERAN PRESCHOOL	FACILITY NUMBER: 360910037
	VISIT DATE: 12/09/2021

NARRATIVE

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It was determined the child sustained “nursemaid elbow” while at school when staff was assisting the child getting up from taking a nap and staff did not intentionally hurt the child. Although the child sustained the injury, the investigator couldn’t determine if the injury was due to staff’s neglect.

Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is UNSUBSTANTIATED.

Exit interview conducted with director, report, appeal right and Notice of Site Visit provided to the director

LPA observed director post notice. Director will post notice for 30 days.

This report must be made available upon request to the public for three years.

SUPERVISOR'S NAME: Gilbert Sena	TELEPHONE: (951) 782-4844
LICENSING EVALUATOR NAME: Patricia Berry	TELEPHONE: (951) 782-4952
LICENSING EVALUATOR SIGNATURE:	DATE: 12/09/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2021

LIC9099 (FAS) - (06/04)

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