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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 360910509
Report Date: 04/15/2022
Date Signed: 04/15/2022 02:03:02 PM

Substantiated


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
02/22/2022 and conducted by Evaluator Karrene Phillips
COMPLAINT CONTROL NUMBER: 09-CC-20220222112204
FACILITY NAME:CHILDTIME CHILDREN'S CENTERFACILITY NUMBER:
360910509
ADMINISTRATOR:CHARLENE BUNNELL-MCALISTERFACILITY TYPE:
830
ADDRESS:3656 RIVERSIDE DR.TELEPHONE:
(909) 591-9169
CITY:CHINOSTATE: CAZIP CODE:
91710
CAPACITY:32CENSUS: DATE:
04/15/2022
UNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:TIME COMPLETED:
02:05 PM
ALLEGATION(S):
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Record Keeping - Staff does not ensure children's immunization records are up to date
INVESTIGATION FINDINGS:
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On April 15, 2022, Licensing Program Analyst (LPA) Kay Phllips arrived at Child Time Children’s Center to conclude the investigation regarding the above allegations. LPA conducted a tour of the facility and the census was taken. During the investigation interviews were conducted with pertinent parties and documentation was collected.

On February 22, 2022 a complaint was received alleging the facility was violating Record Keeping. It was noted the immunization records were never submitted to the facility staff. During the record review of Child # 1 file, it was discovered that the immunization records were missing from the file. During the inspection the Director was unable to locate them and stated there were no immunization records available for review for Child #1.

Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Karrene PhillipsTELEPHONE: 951-970-1161
LICENSING EVALUATOR SIGNATURE:

DATE: 04/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 3
Control Number 09-CC-20220222112204
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: CHILDTIME CHILDREN'S CENTER
FACILITY NUMBER: 360910509
VISIT DATE: 04/15/2022
NARRATIVE
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Based on all the information obtained from pertinent parties, documentation, records review during inspection, the department has determined the preponderance of evidence standard has been met, therefore the above allegations is found to be SUBSTANTIATED.

See LIC 9099-D for deficiencies.

Exit interview was conducted with Christina Hurtado, Assistant Director. A copy of this report, Notice of Site Visit, and Appeal Rights were provided. The Notice of Site Visit must be posted for 30 day. A copy of this report must be made available to the public for three years upon request.
SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Karrene PhillipsTELEPHONE: 951-970-1161
LICENSING EVALUATOR SIGNATURE:

DATE: 04/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 09-CC-20220222112204
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: CHILDTIME CHILDREN'S CENTER
FACILITY NUMBER: 360910509
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/15/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/19/2022
Section Cited
CCR
10122.1(a)
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Immunizations: Prior to admission...children shall be immunized against diseases as required by the California Code of Regulations, Title 17...Section 600.

This requirement was not met as evidenced by:
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The director will submit a written statement to the Department as to how the facility will ensure the regulation is met. The letter will be submitted to the LPA by POC date.
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During the records review, there were no immunization records for Child 1, as they were never submitted to the facility upon admission which poses a potential health, safety, or personal rights risk to persons in care.
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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: Aaron RossTELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Karrene PhillipsTELEPHONE: 951-970-1161
LICENSING EVALUATOR SIGNATURE:

DATE: 04/15/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 3