364813098-1-7-2020-09-CC-AROS-BLDQVD-20200201113007

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 364813098
Report Date: 01/07/2020
Date Signed: 01/07/2020 12:04:25 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
12/03/2019 and conducted by Evaluator Blanca Ruiz-Silva

PUBLIC

COMPLAINT CONTROL NUMBER: 09-CC-20191203104825

FACILITY NAME:	PSD-RIALTO EUCALYPTUS HEAD START		FACILITY NUMBER:	364813098
ADMINISTRATOR:	LUZ GONZALEZ		FACILITY TYPE:	850
ADDRESS:	485 N. EUCALYPTUS AVENUE		TELEPHONE:	(909) 421-7180
CITY:	RIALTO	STATE: CA	ZIP CODE:	92376
CAPACITY:	120	CENSUS: 80	DATE:	01/07/2020
		UNANNOUNCED	TIME BEGAN:	10:10 AM
MET WITH:	Mrs. Luz Gonzalez		TIME COMPLETED:	12:15 PM

ALLEGATION(S):

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Facility staff failed to seek medical attention for the children in a timely manner
Facility staff failed to notify the child's authorized representative of the incident

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Blanca Ruiz-Silva arrived at the facility to conclude an investigation for the above allegations, prior visit was made on 12/05/19 regarding the above allegation.
LPA met with Site Supervisor, Mrs. Luz Gonzalez at the time of the inspection and stated the purpose of the investigation. The center was toured and a census were taken. It was alleged that on/or about the last week of 11/2019, Children’s Personal Rights were violated while in care.
During the initial inspection on 12/05/19, LPA Ruiz-Silva conducted interviews with pertinent parties present at the facility. Records relevant to the investigation were reviewed and additional documents were obtained.

It was alleged that facility staff failed to seek medical attention for the children in a timely manner, in addition to staff failing to notify the child's authorized representative of the incident.

The following information was disclosed on/or about the last week of 11/2019 at approximately 8:15 a.m. a child in care was noticed acting strangely. Staff observed a change in the child’s behavior such as child started talking very fast and/or jittery.
Please see LIC 9099C and LIC 9099D.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Aaron Ross	TELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Blanca Ruiz-Silva	TELEPHONE: (951) 233-5594
LICENSING EVALUATOR SIGNATURE:	DATE: 01/07/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/07/2020

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-20191203104825

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: PSD-RIALTO EUCALYPTUS HEAD START	FACILITY NUMBER: 364813098
	VISIT DATE: 01/07/2020

NARRATIVE

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Staff reported noticing a child talking excessively in a repetitively unusual way. Staff described observing a change in child’s behavior upon arrival to the classroom from 8:15 a.m. until 11:30 a.m. Child’s behavior was explained as talking very fast and stating the same sentences multiple time for approximately 30 minutes. Although child was following instructions and listening to staff, child appeared to be jittery. Staff repeatedly redirected the child to sit down, but child continues talking to classmates repeating the same sentences and moving around.

It was revealed by staff that multiple unusual incidents were noticed during the course of the school day related to the same child. Therefore, the 1^st staff who noticed the 1^st incident reported her observations to the 2^nd staff. 2^nd staff described a second incident with the child and expressed concerns of child looking agitated and/or hyperactive, but she continue with her daily routine.
It was until the end of the school day, when legal guardian arrived at the facility to pick up the child, and he/she questioned staff about the child’s bizarre behavior. Staff then brought it to the attention of the legal guardian. Child was taken to the doctor due to this incident and child received medical attention. Child is no longer attending the facility.
Based on the information obtained during the investigation and per Staff own admission the preponderance of evidence standard has met. The above allegations are SUBSTANTIATED

SEE LIC 9099-D for the deficiencies cited

An exit interview was conducted with Site Supervisor, Mrs. Luz Gonzalez. Appeal rights were explained and a copy of this report and LIC 9224 were given to facility representative. A NOTICE OF SITE VISIT WAS ISSUED, and LPA verified that it was POSTED IN A PROMINENT LOCATION before leaving the facility. Site Supervisor understands that it must remain posted for THE NEXT 30 DAYS ALONG WITH A COPY OF ALL TYPE A DEFICIENCIES (LIC 9099D) CITED DURING THIS INSPECTION.
A COPY OF ALL TYPE A DEFICIENCIES CITED DURING THIS INSPECTION MUST ALSO BE IMMEDIATELY (within 24 hours of the child’s next day in care) GIVEN TO THE PARENTS OF ALL CHILDREN ENROLLED IN THE CHILD CARE FACILITY AND ANY CHILDREN ENROLLED INTO THE CHILD CARE FACILITY OVER THE NEXT 12 MONTHS.

THIS REPORT MUST BE AVAILABLE TO THE PUBLIC FOR THREE YEARS.

SUPERVISOR'S NAME: Aaron Ross	TELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Blanca Ruiz-Silva	TELEPHONE: (951) 233-5594
LICENSING EVALUATOR SIGNATURE:	DATE: 01/07/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/07/2020

LIC9099 (FAS) - (06/04)

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Control Number 09-CC-20191203104825

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: PSD-RIALTO EUCALYPTUS HEAD START	FACILITY NUMBER: 364813098
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/07/2020

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 01/08/2020 Section Cited CCR 101226.3(b)	1 2 3 4 5 6 7	Observation of the Child: (b) Any unusual behavior, any injury or signs of illness requiring assessment and/or administration of first aid by staff shall be reported to the child's authorized representative and recorded in the child's record. This requirement was not met as evidence by: At approximately 08:15 am,	1 2 3 4 5 6 7	Site supervisor agrees to provide staff with a training memo on Personal Rights/ Observation of a child and submit written statement of understanding from staff with a date and their signatures by 01/08/2020. In addition, Site supervisor will provide in service training on Personal Rights/ Observation of a child and will provide the department with sign in sheet/ agenda of topics with date and time of training by 01/14/2020
	8 9 10 11 12 13 14	Staff reported noticing a child in care acting strangely by talking excessively in a repetitively way for approximately 30 minutes. Staff described observing a change in child’s behavior upon arrival to the classroom until the end of the school day. Parent was not notified. Child was taken to the doctor due to this incident and child received medical attention.	8 9 10 11 12 13 14	>> Child is no longer attending the facility. “This poses an immediate risk to the Health and Safety of the children in care”.
Type A 01/08/2020 Section Cited CCR 101223(a)(2)	1 2 3 4 5 6 7	Personal Rights: Every child shall be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs. This requirement was not met as evidence by: Child was exhibiting an unusual behavior concerning to staff. The 1st staff who noticed the 1st incident reported her observations to the 2nd staff.	1 2 3 4 5 6 7	Site supervisor agrees to provide staff with a training memo on Personal Rights/ Observation of a child and submit written statement of understanding from staff with a date and their signatures by 01/08/2020. In addition, Site supervisor will provide in service training on Personal Rights/ Observation of a child and will provide the department with sign in sheet/ agenda of topics with date and time of training by 01/14/2020
	8 9 10 11 12 13 14	2nd staff describe a second incident with the child and expressed that child seemed agitated and/or hyperactive, but she continue with her daily routine without reassessing the child’s condition. Child was taken to the doctor due to the incident. Child is no longer attending the facility.	8 9 10 11 12 13 14	>> “This pose an immediate health and safety risk to the children by how staffs are handling children in care”.

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 Ross	TELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Blanca Ruiz-Silva	TELEPHONE: (951) 233-5594
LICENSING EVALUATOR SIGNATURE:	DATE: 01/07/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/07/2020

LIC9099 (FAS) - (06/04)

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