370805460-6-24-2021-20-CC-CGRY-C4W64B-20210713202826

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 370805460
Report Date: 06/24/2021
Date Signed: 06/24/2021 03:43:01 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/14/2021 and conducted by Evaluator Marie Hernandez

PUBLIC

COMPLAINT CONTROL NUMBER: 20-CC-20210414134954

FACILITY NAME:	ALPINE COUNTRY CARE CLUB		FACILITY NUMBER:	370805460
ADMINISTRATOR:	MICHELLE MARKS		FACILITY TYPE:	840
ADDRESS:	8770 HARBISON CANYON ROAD		TELEPHONE:	(619) 445-3553
CITY:	ALPINE	STATE: CA	ZIP CODE:	91901
CAPACITY:	65	CENSUS: 28	DATE:	06/24/2021
		UNANNOUNCED	TIME BEGAN:	01:50 PM
MET WITH:	Michelle Marks, Facility Director		TIME COMPLETED:	03:45 PM

ALLEGATION(S):

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Teacher yells at the children.

INVESTIGATION FINDINGS:

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On June 24, 2021 at 1:50 PM, Licensing Program Analyst (LPA), Marie Hernandez conducted an unannounced complaint investigation inspection to deliver the complaint findings with the Facility Director, Michelle Marks. Present are twenty eight children with five staff. Through the course of the complaint investigation, LPA conducted several confidential interviews with the Facility Representatives, fourteen day care children, twelve day-care parents, and five staff including the witnesses. During the initial complaint investigation on 04/19/2021, LPA conducted a virtual inspection of the facility due to the Covid-19 State of Emergency. The witnesses stated they heard staff #1 speaking inappropriately and yelling at child #1 in the presence of the other children because of a restroom incident. This poses an immediate health and safety risk to children in care.

Based on the evidence obtained and the confidential interviews, we have found there is a preponderance of evidence to prove the alleged violation of the “Teacher yells at the children” occurred, therefore the allegation is determined to be SUBSTANTIATED. Title 22 Regulations, Section 101223 Personal Rights is being cited on the attached LIC 9099D.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Cynthia Gray	TELEPHONE: (619) 767-2258
LICENSING EVALUATOR NAME: Marie Hernandez	TELEPHONE: (619) 767-2244
LICENSING EVALUATOR SIGNATURE:	DATE: 06/24/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2021

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 20-CC-20210414134954

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: ALPINE COUNTRY CARE CLUB	FACILITY NUMBER: 370805460
	VISIT DATE: 06/24/2021

NARRATIVE

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LPA Marie Hernandez explained the complaint investigation report and the appeal rights with the Facility Director, Michelle Marks. The following reports were provided to the Facility Director: LIC9099, LIC9099-C, LIC9099-D, Appeal Rights (LIC 9058), Acknowledgement of Receipt of Licensing Reports (LIC 9224) and the Notice of Site Visit (LIC 9213). The Director was advised that the Type A Complaint Investigation Report and the Notice of Site Visit shall be posted for 30 days and shall provide a copy of the licensing report along with the Acknowledgement of Receipt of Licensing Reports (LIC 9224) to the parents/guardians of children in care at the facility and to the parents/guardians of children newly enrolled at the facility for the next 12 months. In addition, the LIC 9224 must be signed by parents/guardians of children currently in enrolled and by parents/guardians of children newly enrolled at the facility and placed in each child’s record for the next 12 months. The Director stated it is understood.

SUPERVISOR'S NAME: Cynthia Gray	TELEPHONE: (619) 767-2258
LICENSING EVALUATOR NAME: Marie Hernandez	TELEPHONE: (619) 767-2244
LICENSING EVALUATOR SIGNATURE:	DATE: 06/24/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2021

LIC9099 (FAS) - (06/04)

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Control Number 20-CC-20210414134954

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: ALPINE COUNTRY CARE CLUB	FACILITY NUMBER: 370805460
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/24/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 06/25/2021 Section Cited CCR 101223(a)(1)	1 2 3 4 5 6 7	101223 Personal Rights (a) The licensee shall ensure that each child is accorded the following personal rights: (1) To be accorded dignity in his/her personal relationships with staff and other persons. This requirement was not met as evidenced by:	1 2 3 4 5 6 7	The Director stated she will conduct an in-service to all staff on children's personal rights, and will submit a written plan to ensure that the children's personal rights are not violated again by 06/25/2021. The Director stated she will submit the plan of correction to LPA by 06/25/2021
	8 9 10 11 12 13 14	Based on confidential interviews with several witnesses and pertinent information obtained, the facility did not ensure that the children were accorded personal rights when staff # 1 violated the children’s personal rights by speaking inappropriately and yelling at child #1 in the presence of the other children. This poses an immediate health and safety risk to children in care.	8 9 10 11 12 13 14	LPA also conducted a consultation with the Director. The appeal rights were discussed and provided.
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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: Cynthia Gray	TELEPHONE: (619) 767-2258
LICENSING EVALUATOR NAME: Marie Hernandez	TELEPHONE: (619) 767-2244
LICENSING EVALUATOR SIGNATURE:	DATE: 06/24/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2021

LIC9099 (FAS) - (06/04)

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