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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 360910507
Report Date: 06/17/2021
Date Signed: 06/17/2021 03:00:39 PM

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:CHILDTIME CHILDREN'S CENTERSFACILITY NUMBER:
360910507
ADMINISTRATOR:TONI GAVELLFACILITY TYPE:
850
ADDRESS:3656 RIVERSIDE DR.TELEPHONE:
(909) 591-9169
CITY:CHINO,STATE: CAZIP CODE:
91710
CAPACITY:69CENSUS: 40DATE:
06/17/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Toni Gavell - DirectorTIME COMPLETED:
03:15 PM
NARRATIVE
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Licensing Program Analysts (LPAs), Rachel Zeron and Carlos Martinez, arrived to follow up on an Unusual Incident Report (UIR) that was submitted to Community Care Licensing (CCL) by the facility on 06/03/21. LPA met with Toni Gavell to discuss the incident.

On 06/03/21, a UIR was received by CCL stating that Child #1 was left behind in the classroom while the rest of the class went to the playground for water play. According to the Assistant Director, Tina Hurtado, she noticed he was left alone in the classroom when she coincidently walked in the classroom and observed him alone. The child was then taken to join his classroom and Staff were informed of what had occurred.

See LIC 809D for deficiencies cited. This is a ZERO-TOLERANCE violation that presented and immediate risk to the child's safety. An exit interview was conducted, appeal rights discussed and a copy of this report was provided.

THE NOTICE OF SITE VISIT IS TO BE POSTED IN A PROMINENT LOCATION AT THE FACILITY FOR THE NEXT 30 DAYS ALONG WITH A COPY OF THE TYPE A DEFICIENCY (LIC809D) CITED DURING THIS INSPECTION. A COPY OF THE TYPE A DEFICIENCY CITED DURING THIS INSPECTION MUST ALSO BE IMMEDIATELY (within 24 hours of the child’s next day in care) GIVEN TO THE PARENTS OF ALL CHILDREN ENROLLED IN THE CHILD CARE FACILITY AND ANY CHILDREN ENROLLED INTO THE CHILD CARE FACILITY OVER THE NEXT 12 MONTHS.

A copy of this report must be made available to the public, at the facility site, for 3 years.
SUPERVISOR'S NAME: Kimberly WilliamsTELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Rachel ZeronTELEPHONE: (951) 782-4200
LICENSING EVALUATOR SIGNATURE:

DATE: 06/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2021
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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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 ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: CHILDTIME CHILDREN'S CENTERS
FACILITY NUMBER: 360910507
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/17/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/18/2021
Section Cited

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RESPONSIBILITY FOR PROVIDING CARE AND SUPERVISION:

No child(ren) shall be left without the supervision, including visual observation, of a teacher at any time. This requirement was not met as evidenced by: LPA Zeron confirmed that Child #1 was left alone in a classroom
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with no supervision.

This is a Zero-Tolerance violation that presented and immediate risk to the child's safety.
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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: Kimberly WilliamsTELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Rachel ZeronTELEPHONE: (951) 782-4200
LICENSING EVALUATOR SIGNATURE:
DATE: 06/17/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/17/2021
LIC809 (FAS) - (06/04)
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