364840850-6-28-2022-09-CC-RZEN-CFTSFY-20220628135107

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 364840850
Report Date: 06/28/2022
Date Signed: 06/28/2022 01:51:22 PM

Document Has Been Signed on 06/28/2022 01:51 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:	VIOLA FAMILY CHILD CARE		FACILITY NUMBER:	364840850
ADMINISTRATOR:	VIOLA, CYNTHIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(909) 993-4134
CITY:	CHINO HILLS	STATE: CA	ZIP CODE:	91709
CAPACITY:	14	CENSUS: 9	DATE:	06/28/2022
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Cynthia Viola		TIME COMPLETED:	02:15 PM

NARRATIVE

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Licensing Program Analyst (LPA) Rachel Zeron arrived at the facility on a case management visit to follow up on an Unusual Incident Report (UIR) submitted by the facility on 06/09/2022. At the time of visit, LPA toured the facility (specifically where the incident took place), took census, and met with Licensee, Cynthia Viola to discuss the incident. During the visit, LPA also spoke with the subject child, and licensee’s daughter. The incident occurred on 06/09/2022, the subject child was sitting at the table outside in the back yard talking with Licensee, while the other children played. Licensee’s daughter was sitting on the grass next to the table with her small dog, while the dog chewed on a bone. The subject decided to get up and walked around the table and quickly learned down towards the dog, this is when the dog snapped and lunged for the subject. According to the licensee, the small dog has never been aggressive towards anyone before and because the dog was gnawing on a bone, the dog became possessive. The Licensee quickly took the subject inside and evaluated the injuries. The skin was slightly broken on the site of the bite, the dog had bitten the subject’s upper lip and scratched the child under the eye. First aid was administered by the Licensee, the Licensee immediately contacted the subject child's parent. Medical attention was sought by the subject child's parents; however, this was only precautionary, parents were given an antibiotic for the injury. The subject child's mother was interviewed, the child’s injuries were minor, and the child returned to the daycare on 06/27/2022.

Based on the information obtained during the visit, as well as an inspection of the backyard area and subject’s injuries (photographs of file). LPA found that the child’s personal rights were violated and will be cited in accordance with Title 22 regulations . (809D attached)

An exit interview was held with Licensee, Cynthia Viola. A Notice of Site visit was issued and shall be posted for the next 30 days, along with a copy of this report. This report shall be public record for three years.

SUPERVISOR'S NAME: Kimberly Williams	TELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Rachel Zeron	TELEPHONE: (951) 782-4200
LICENSING EVALUATOR SIGNATURE:	DATE: 06/28/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2022

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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Document Has Been Signed on 06/28/2022 01:51 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

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

FACILITY NAME: VIOLA FAMILY CHILD CARE	FACILITY NUMBER: 364840850
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/28/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 06/29/2022 Section Cited	1 2 3 4 5 6 7	Personal Rights Each child receiving services from a family child care home shall have certain rights that shall not be waived or abridged by the licensee regardless of consent or authorization from the child's authorized representative. These rights include, but are not limited to, the following: To receive safe, healthful, and comfortable accommodations This requirement was not met as evidenced by:
	8 9 10 11 12 13 14	Although the Licensee was present and unable to prevent the dog from lunging up and injuring the child, the child's personal rights were violated. This is an immediate risk to the health and safety of children in care	8 9 10 11 12 13 14	Licensee also indicated that the dog is no longer around the children and is kept upstairs, where the day-care is off limits. The Licensee was proactive on ensurring the children's safety.
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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) 782-4200
LICENSING EVALUATOR NAME: Rachel Zeron	TELEPHONE: (951) 782-4200
LICENSING EVALUATOR SIGNATURE:	DATE: 06/28/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2022

LIC809 (FAS) - (06/04)

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