364805911-9-20-2019-09-CC-AROS-BH2MKF-20191017094042

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 364805911
Report Date: 09/20/2019
Date Signed: 09/20/2019 01:35:37 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
08/07/2019 and conducted by Evaluator Kim Leung

PUBLIC

COMPLAINT CONTROL NUMBER: 09-CC-20190807161807

FACILITY NAME:	KUBIS FAMILY CHILD CARE		FACILITY NUMBER:	364805911
ADMINISTRATOR:	KUBIS, ROSANN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(909) 823-0303
CITY:	RIALTO	STATE: CA	ZIP CODE:	92377
CAPACITY:	14	CENSUS: 6	DATE:	09/20/2019
		UNANNOUNCED	TIME BEGAN:	10:55 AM
MET WITH:	Rosann Kubis		TIME COMPLETED:	01:39 PM

ALLEGATION(S):

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Licensee inappropriately disciplines child(ren) in care.

Child received nail scratches and bruise from licensee.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Kim Leung returned to the facility with LPA Samuel Lopez to continue the investigation on the above allegation. LPAs met with licensee Rosann Kubis and stated the purpose of the visit. It was alleged that licensee hit and yelled at a child care child as a form of discipline. After the initial investigation on 8/9/2019, additional allegation was received on 8/13/2019 alleging that the child received nail scratches on the back and bruise on the buttock from the licensee when licensee put the child on a chair at the family child care home. During the investigation process, records were reviewed, interviews with children and provider were conducted and provider-child interactions were observed. Additional interview was conducted prior to LPA's return this date. LPAs observed no personal rights violations at time of both visits. Licensee denied the allegations. Licensee denied yelling at children or physically punishing children. Licensee denied handling children in an aggressive manner. Licensee stated that when children were not following instructions, the children would be placed in time out.

(TO BE CONTINUED ON NEXT PAGE)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Aaron Ross	TELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Kim Leung	TELEPHONE: (951) 529-4713
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-20190807161807

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: KUBIS FAMILY CHILD CARE	FACILITY NUMBER: 364805911
	VISIT DATE: 09/20/2019

NARRATIVE

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As stated by the licensee, the maximum time children being placed in time out goes by their ages. As stated by licensee, time out is not exceeding one minute per year of the children's ages. Licensee denied causing any injuries to children.

Conflicting information was received during the investigation in regard to whether the child received corporal punishment at the family child care or not. In addition, based upon the information received during the investigation process, the Department was not able to determine whether the injuries occurred at the family child care home or not. Based upon the information gathered throughout the investigation process, there is not a preponderance of evidence to corroborate the allegations of inappropriate disciplines or inflicted injuries.

Based upon the information gathered, there is not a preponderance of evidence to support or dismiss the allegations. The above allegations are ruled unsubstantiated at this time.

Exit interview was conducted with licensee Rosann Kubis, Notice of Site Visit was issued and must be posted for 30 days. A copy of this report was left at the facility.

This report must be made available at the facility for 3 years for public review upon request.

SUPERVISOR'S NAME: Aaron Ross	TELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Kim Leung	TELEPHONE: (951) 529-4713
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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