360911528-9-30-2019-09-CC-KWIS-BGK4UY-20191001192528

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 360911528
Report Date: 09/20/2019
Date Signed: 09/30/2019 11:39:28 AM

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
08/27/2019 and conducted by Evaluator Sharleen Robinson

PUBLIC

COMPLAINT CONTROL NUMBER: 09-CC-20190827143147

FACILITY NAME:	HIGHLAND HEAD START		FACILITY NUMBER:	360911528
ADMINISTRATOR:	ROBYN JOHNSON		FACILITY TYPE:	850
ADDRESS:	26887 5TH STREET		TELEPHONE:	(909) 425-0785
CITY:	HIGHLAND	STATE: CA	ZIP CODE:	92346
CAPACITY:	60	CENSUS:	DATE:	09/20/2019
		UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Lead Teacher, Elizabeth Harkey		TIME COMPLETED:	11:45 AM

ALLEGATION(S):

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Reporting Requirements: Staff failed to notify authorized representative of incident

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Sharleen Robinson arrived at the facility to conclude a complaint investigation that was initiated on August 30, 2019. LPA met with Lead Teacher, Elizabeth Harkey. A census was taken, and the facility was toured. It is alleged that Staff failed to notify authorized representative of an incident.

During the investigation, LPA Robinson made observations, conducted interviews with Licensee and all other relevant individuals pertinent to this investigation.
It was alleged that a child urinated on themselves and their shoes, the child did not have an extra pair of shoes, therefore staff placed the child in a pair of loaner socks that belongs to the facility. When the child’s representative asked staff why the child was not wearing shoes, staff was unable to explain to the child’s representative.

See LIC9099C for the remainder of the report

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Kimberly Williams	TELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Sharleen Robinson	TELEPHONE: (951) 233-7183
LICENSING EVALUATOR SIGNATURE:	DATE: 09/20/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2019

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-20190827143147

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: HIGHLAND HEAD START	FACILITY NUMBER: 360911528
	VISIT DATE: 09/20/2019

NARRATIVE

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During staff interviews, It was disclosed that at approximately 10:30am on or about August 27, 2019, a child urinated on themselves; their clothing and their shoes, as a result, staff cleaned the child, changed their clothing and placed the child in a extra pair of clean socks that belongs to the facility. Staff admitted due to mis-communication between staff, they failed to call the child’s representative to advise the representative of what transpired. Staff apologized to the representative for not notifying them.

LPA discovered it is facility policy to notify representatives when children do not have shoes. Per page 16 of the Parent Handbook, children are required to wear shoes and socks while in care at the facility.

The evidence gathered during the investigation revealed that staff members admitted to not notifying a representative that a child did not have shoes to wear. LPA discovered it is facility policy to notify representative when children do not have shoes to wear, therefore the preponderance of evidence standard has been met therefore, the above personal Accountability allegation is found to be SUBSTANTIATED. See LIC9099D for citation.

SUPERVISOR'S NAME: Kimberly Williams	TELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Sharleen Robinson	TELEPHONE: (951) 233-7183
LICENSING EVALUATOR SIGNATURE:	DATE: 09/20/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2019

LIC9099 (FAS) - (06/04)

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Control Number 09-CC-20190827143147

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: HIGHLAND HEAD START	FACILITY NUMBER: 360911528
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/20/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 10/08/2019 Section Cited CCR 101214(a)	1 2 3 4 5 6 7	101214(a) Accountability The licensee, whether an individual or other entity, is accountable for the general supervision of the licensed child care center and for the establishment of policies concerning its operation. This requirement was not met as evidenced by: Staff admitting a child urinated on themselves; their clothing and their shoes, as a result staff cleaned the child, changed their clothing and placed the child in an extra pair of clean socks that belonged to the facility.	1 2 3 4 5 6 7	1. Immediately the facility agrees to adhere to their established policies and procedures surrounding reporting incidents to children representatives. 2. The Director agrees to conduct an In-service training with all staff regarding accountability. The director agrees to provide LPA with the training agenda and staff attendance sheet by the due date of October 8, 2019 to: sharleen.robinson@dss.ca.gov
	8 9 10 11 12 13 14	Staff failed to call the child’s representative to advise the representative of what transpired due to miscommunication between staff. Staff also admitted it is their policy to notify representatives when children do not have shoes. This is a potential risk to the health and safety of children in care.	8 9 10 11 12 13 14
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	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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 Williams	TELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Sharleen Robinson	TELEPHONE: (951) 233-7183
LICENSING EVALUATOR SIGNATURE:	DATE: 09/20/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2019

LIC9099 (FAS) - (06/04)

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