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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364818441
Report Date: 08/23/2022
Date Signed: 08/23/2022 04:04:27 PM


Document Has Been Signed on 08/23/2022 04:04 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501



FACILITY NAME:PSD/FONTANA CITRUS HEAD STARTFACILITY NUMBER:
364818441
ADMINISTRATOR:ALONDRA LADISONFACILITY TYPE:
850
ADDRESS:9315 CITRUS AVENUETELEPHONE:
(909) 428-8496
CITY:FONTANASTATE: CAZIP CODE:
92335
CAPACITY:140CENSUS: 12DATE:
08/23/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
03:33 PM
MET WITH:Alondra Ladison/DirectorTIME COMPLETED:
04:34 PM
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On 8/23/2022 at 2:30 pm, Licensing Program Analyst Patricia Berry conducted a case management incident investigation regarding an Unusual Incident Report called in to Community Care Licensing on 8/12/2022.LPA followed up on the incident. LPA was granted access into the facility and met with director Alondra Ladison. LPA toured facility and took a census. LPA interviewed staff.

It was alleged on 8/12/2022 a child was disruptive in the classroom. LPA interviewed 4 staff who stated there was an incident that did occur of a child who was disruptive in the classroom. Director stated she has followed the policies and procedures of the admission agreement for children who have challenging behaviors. The director stated the child is being re-evaluated and that point will determine if this child can return to school or need a school to meet the child's needs.

At this time LPA has determined there is no violation of Title 22 regulations.


Exit interview conducted with director, report, appeal rights and Notice of Site Visit issued to director.

Notice of Site Visit must be posted for 30 days.
SUPERVISOR'S NAME: Gilbert SenaTELEPHONE: (951) 782-4844
LICENSING EVALUATOR NAME: Patricia BerryTELEPHONE: (951) 782-4952
LICENSING EVALUATOR SIGNATURE:
DATE: 08/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/23/2022
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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