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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 360911276
Report Date: 01/28/2022
Date Signed: 01/28/2022 02:20:50 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:SBCSS ADELANTO STATE PRESCHOOLFACILITY NUMBER:
360911276
ADMINISTRATOR:NANCY ALVARADOFACILITY TYPE:
850
ADDRESS:17927 JONATHAN STREETTELEPHONE:
(760) 246-3396
CITY:ADELANTOSTATE: CAZIP CODE:
92301
CAPACITY:48CENSUS: DATE:
01/28/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:51 PM
MET WITH:Nancy AlvardoTIME COMPLETED:
02:20 PM
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On 1/28/2022 Licensing Program Analyst (LPA) Carol Heath conducted a Case management incident inspection to follow up on an Unusual Incident reported to the department on 10/08/2021. This inspection was conducted virtually. LPA Heath spoke with Nancy Alvardo (Operations Manger for State Preschool).

Description of the incident: On 10/08/2021 at 12:05 P.M.an SBCSS Special Education Teacher who is located in the building next door to the classroom stated that her classroom assistant witnessed a State Preschool Staff member throw down a child on the concrete floor a few minutes after arrival. She stated that upon arrival they saw the student visibly upset during drop off at 11:45 a.m. and arrived with no shoes or socks and the student was wearing a pink dress.

The investigation consisted of interviews with staff and teachers and a review of supportive documents including a police report. Based on interviews conducted, and reviewed police report, it is determined that the preschool teacher was protecting the child’s from running to the facility parking lot. According to teacher and parent interview, the child constantly throws herself on the ground with temper tantrums. The parent did not have any concern about the facility or teacher.

There was insufficient evidence to conclude that were was inappropriate behavior during the time the incident occurred. Therefore, the incident was found without merit and no citation will be issued at this time.

Exit interview conducted and report was reviewed with the facility representative Nancy Alvarado.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol HeathTELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:

DATE: 01/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2022
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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