364844072-9-15-2023-12-CC-BIBE-CVPRP7-20230915131128

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 364844072
Report Date: 09/15/2023
Date Signed: 09/15/2023 01:11:31 PM

Document Has Been Signed on 09/15/2023 01:11 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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME:	SBCSS BRADACH STATE PRESCHOOL		FACILITY NUMBER:	364844072
ADMINISTRATOR:	NANCY ALVARADO		FACILITY TYPE:	850
ADDRESS:	15550 BELLFLOWER STREET		TELEPHONE:	(760) 246-5016
CITY:	ADELANTO	STATE: CA	ZIP CODE:	92301
CAPACITY: 24	TOTAL ENROLLED CHILDREN: 24	CENSUS: 19	DATE:	09/15/2023
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Leticia Castaneda		TIME COMPLETED:	01:30 PM

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On September 15, 2023, Licensing Program Analyst (LPA) Babatunde Ibitoye met with Lead Teacher Leticia Castaneda to conduct an unannounced case management inspection. The purpose of the case management was to follow up on a self reported unusual incident report (UIR) submitted to the Department on May 26, 2023

Description of incident: On 5/19/23 at 11 a.m. parents of C#1, came to the school to ask questions about a possible injury at school. They stated that on 5/18/23 at approximately 4:00 pm C#1 was crying and complaining that ‘it hurt’. They noticed a fresh cut on C#1 private area and C#1 told them that she had fallen from the swings at school. They took her to the doctor and the doctor suggested they call the police. on 5/23, the Deputy came to the school and asked for a statement, and provided a case number. C#1 did not attend school on 5/19 or 5/22 but did return on 5/23.

On the date of the alleged incident, 5/18 there were 21 students, and 4 staff members present. All students were visually supervised throughout the day as were overstaffed. All staff confirmed that C#1 did not obtain any injury nor was she playing on the swings after the outdoor play ended at noon, C#1 behavior was normal, and did not express any pain. Upon departure, C#1 left normal and did not express any pain. CPS was contacted on 5/26/23.

During the investigation, LPA conducted interviews with all that was involved. The interviews reviewed revealed conflicting statements regarding the incident. Currently, there is no preponderance of evidence to prove or disprove that the injury occurred while the child was in care.

No deficiency is cited at this time.

An exit interview is conducted, and a copy of this report, appeal rights, and notice of the site visit are discussed with lead Teacher Leticia Castaneda.

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Babatunde Ibitoye
LICENSING EVALUATOR SIGNATURE:	DATE: 09/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2023

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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