372005376-9-27-2021-10-CC-CMAZ-C7SV29-20211014160247

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 372005376
Report Date: 09/27/2021
Date Signed: 09/27/2021 01:33:26 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/20/2021 and conducted by Evaluator James Wilkerson

PUBLIC

COMPLAINT CONTROL NUMBER: 10-CC-20210820165824

FACILITY NAME:	CREATIVE BEGINNING, A		FACILITY NUMBER:	372005376
ADMINISTRATOR:	PAULETTE SHRYOCK		FACILITY TYPE:	850
ADDRESS:	409 E. FALLBROOK STREET		TELEPHONE:	(760) 728-7600
CITY:	FALLBROOK	STATE: CA	ZIP CODE:	92028
CAPACITY:	56	CENSUS: 29	DATE:	09/27/2021
		UNANNOUNCED	TIME BEGAN:	12:20 PM
MET WITH:	Rosemary Fisher		TIME COMPLETED:	01:45 PM

ALLEGATION(S):

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Daycare child sustained injury while in care.

Staff did not provide adequate supervision.

Staff did not report incident to daycare child's responsible party.

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPAs) James Wilkerson and Sumayya Habeebulla arrived at this faclity to conclude an investigation into the above allegations. An initial visit was conducted on 08/25/21 and extended at that time. LPAs toured the facility and conducted census. During the course of this investigation three staff were interviewed. The subject child is not verbal. There was an allegation that a child received an injury while in care, and allegations that the supervision was inadequate and that the incident was not reported to the child's responsible party. Interviews with the three staff members indicate that while there was an injury to a child at this facility it was not caused by a lack of supervision, rather it was just an accident that happened and staff did observe the incident, however, couldn't react quick enough to prevent it from occurring. Staff interviews indicate that the child was accidentally pushed by another child who was swiinging on swing and pushed the other child who tripped because of this and landed on top of the cushioning material which is wood chips. LPAs cannot prove or disprove this allegation. LPAs cannot prove if there was sufficient supervision or not at the time of the incident. SEE LIC 9099C.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Carlos Martinez	TELEPHONE: (951) 782-4950
LICENSING EVALUATOR NAME: James Wilkerson	TELEPHONE: (951) 218-7031
LICENSING EVALUATOR SIGNATURE:	DATE: 09/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2021

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 10-CC-20210820165824

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: CREATIVE BEGINNING, A	FACILITY NUMBER: 372005376
	VISIT DATE: 09/27/2021

NARRATIVE

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There was an allegation that the injury was not reported to the responsible party, staff interviews indicate that the injury did not look serious enough at the time to report the incident. Staff interviews indicate that upon waking up from nap, the injury appeared more serious and was getting ready to contact the responsible party, however the responsible party arrived at the same time the child woke up. LPAs obtained a copy of the Admissions Agreement regarding injuries to children that "in the event of a minor injury, the school will administer first aid and contact the parent if necessary." At the time of the incident the staff didn't deem the injury to be anything more that a very minor injury and this is the reason why the responsible party was not contacted. LPAs cannot verify how serious the injury initially was.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the allegation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

An exit interview was conducted and a Notice of Site Visit was posted.

SUPERVISOR'S NAME: Carlos Martinez	TELEPHONE: (951) 782-4950
LICENSING EVALUATOR NAME: James Wilkerson	TELEPHONE: (951) 218-7031
LICENSING EVALUATOR SIGNATURE:	DATE: 09/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2021

LIC9099 (FAS) - (06/04)

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