364843943-10-16-2019-12-CC-CYAS-BKTSCW-20200114124610

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 364843943
Report Date: 10/16/2019
Date Signed: 10/16/2019 03:37:53 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550

This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/04/2019 and conducted by Evaluator Aaron Mabika

PUBLIC

COMPLAINT CONTROL NUMBER: 12-CC-20191004174207

FACILITY NAME:	ROSITA R. SMITH H.Q. PRESCHOOL, INC.		FACILITY NUMBER:	364843943
ADMINISTRATOR:	ROSITA R. SMITH		FACILITY TYPE:	830
ADDRESS:	1455 E. LYNWOOD DRIVE		TELEPHONE:	(909) 804-8808
CITY:	SAN BERNARDINO	STATE: CA	ZIP CODE:	92404
CAPACITY:	18	CENSUS: 19	DATE:	10/16/2019
		UNANNOUNCED	TIME BEGAN:	02:06 PM
MET WITH:	Rosita Smith		TIME COMPLETED:	03:45 PM

ALLEGATION(S):

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Staff are co-mingling age groups.

INVESTIGATION FINDINGS:

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On 10/16/2019 at 02.00 PM., Licensing Program Analyst (LPA) Aaron Mabika met with above facility's Director, Rosita Smith. LPA was at the facility to conduct an initial ten-day complaint investigation. LPA disclosed the purpose of the investigation and was granted entry into the facility. Upon arrival, LPA verified a census of 19 preschool children and infants in care.

During today's investigation LPA obtained a copy of the facility roster, sign in sheets, and all other pertinent documents. LPA also conducted interviews with staff members, and was informed that the facility has been co-mingling Infants with the 3/4 year age group in the 3/4 Yr age group classroom at pick-upand at drop-off. Based on information obtained, there is preponderance of the evidence to prove that the Director failed to meet the supervision requirements. Therefore the above requirement is substantiated. Appeal rights were provided and discussed with the director and a Type "A" citation was issued.

Director was informed that it is against regulations to have preschool and infants co-mingle. a Type "A" violation was issued.

Exit interview conducted and a copy of this report was left with the director.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 789-6944
LICENSING EVALUATOR NAME: Aaron Mabika	TELEPHONE: (661) 305-7599
LICENSING EVALUATOR SIGNATURE:	DATE: 10/16/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2019

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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