364810707-2-10-2020-09-CC-GSEA-BLPKEJ-20200211065023

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 364810707
Report Date: 01/28/2020
Date Signed: 02/10/2020 04:17:43 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
11/25/2019 and conducted by Evaluator Nelson Zuniga

PUBLIC

COMPLAINT CONTROL NUMBER: 09-CC-20191125101748

FACILITY NAME:	MOUNT ZION CHRISTIAN SCHOOL		FACILITY NUMBER:	364810707
ADMINISTRATOR:	BARABARA YOUNG		FACILITY TYPE:	850
ADDRESS:	224 A W. CALIFORNIA STREET		TELEPHONE:	(909) 988-2280
CITY:	ONTARIO	STATE: CA	ZIP CODE:	91762
CAPACITY:	49	CENSUS: 16	DATE:	01/28/2020
		UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Barbara Young and Richard Young		TIME COMPLETED:	02:20 PM

ALLEGATION(S):

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1. Lack of supervision resulting in child sustaining injury while in care.

2. Facility is operating out of ratio

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Nelson Zuniga conducted an onsite investigation into the above allegations (an initial onsite inspection was conducted on 11/26/2019). It was alleged staff failed to provide adequate supervision resulting in a child sustaining injury (scratches on face) while in care and facility is operating out of ratio. During the investigation, the LPA interviewed all pertinent parties involved, reviewed records, and toured the facility.

It was reported a child in care was picked up at the end of the day by their guardian. While walking the child to the car, the child’s guardian observed scratches on the child's face. Guardian immediately texted staff pictures to inquire about what had happened; but the guardian did not receive a response from staff. Guardian took the child home without going back into the facility to speak to staff; but, did speak to the Director the next day about the incident.
(Continue on LIC9099C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Gilbert Sena	TELEPHONE: (951) 782-4844
LICENSING EVALUATOR NAME: Nelson Zuniga	TELEPHONE: (951) 782-6634
LICENSING EVALUATOR SIGNATURE:	DATE: 01/28/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2020

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-20191125101748

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: MOUNT ZION CHRISTIAN SCHOOL	FACILITY NUMBER: 364810707
	VISIT DATE: 01/28/2020

NARRATIVE

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Staff deny both allegations, stating the child did not have scratches when the guardian picked the child up and how the facility is never out of ratio. LPA conducted two inspection visits at facility (todays visit and the initial visit of 11/26/2019); and on both days, the facility was within the appropriate child teacher ratios.

During the investigation, conflicting statements were obtained from what was reported. The Department has investigated the above allegations and although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove the alleged violations occurred; therefore, the Department’s finding is the allegations are unsubstantiated. Exit interview was conducted, copy of this report provided to representative.

SUPERVISOR'S NAME: Gilbert Sena	TELEPHONE: (951) 782-4844
LICENSING EVALUATOR NAME: Nelson Zuniga	TELEPHONE: (951) 782-6634
LICENSING EVALUATOR SIGNATURE:	DATE: 01/28/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2020

LIC9099 (FAS) - (06/04)

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