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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 376600278
Report Date: 12/18/2019
Date Signed: 12/18/2019 12:02:51 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
11/06/2019 and conducted by Evaluator Grace Curtis
COMPLAINT CONTROL NUMBER: 51-CC-20191106092351
FACILITY NAME:MAAC GOSNELLFACILITY NUMBER:
376600278
ADMINISTRATOR:CLARIBEL ZORRILLAFACILITY TYPE:
850
ADDRESS:139 GOSNELL WAYTELEPHONE:
(760) 736-3066
CITY:SAN MARCOSSTATE: CAZIP CODE:
92069
CAPACITY:112CENSUS: 93DATE:
12/18/2019
UNANNOUNCEDTIME BEGAN:
10:10 AM
MET WITH:Claribel ZorrillaTIME COMPLETED:
11:10 AM
ALLEGATION(S):
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Lack of supervision resulting in inappropriate interactions between children.
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPA's) Leilani Curtis and Selina Siao completed an unannounced inspection for the purpose of delivering the finding for the above allegation. On 11/5/2019 two children were playing inappropriately on the playground. The initial inspection was conducted on 11/12/19. Upon arrival, LPA's met with Assistant Director Jacquelyn Rodrigues Biskupski. At 11:00 a.m. LPA's met with Center Director Claribel Zorrilla. Throughout the investigation, LPA's interviewed several staff members, several parents and the child involved. LPA's also obtained related documentation such as written staff statements. Based on LPA's observations and interviews which were conducted and record reviews, the preponderance of evidence standard has been met, therefore the above allegation is found to be substantiated. California Code of Regulations, Title 22, 101229(a)(1) is being cited on the attached LIC 9099D. An exit interview was conducted with Director. A printed copy of this report as well as a printed copy of the appeal rights was provided and reviewed with Director at the conclusion of the inspection. LPA's observed the Director post notice of site visit which must remain posted for 30 days.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Tashima DanielTELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Grace CurtisTELEPHONE: (619) 767-2235
LICENSING EVALUATOR SIGNATURE:

DATE: 12/18/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 51-CC-20191106092351
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: MAAC GOSNELL
FACILITY NUMBER: 376600278
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/18/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/31/2020
Section Cited
CCR
101229(a)(1)
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Responsibility for Providing Care and Supervision: (1) No child(ren) shall be left without the supervision of a teacher at any time... Supervision shall include visual observation. This requirement was not met as evidenced by:
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The Director stated they will have fewer children on the playground at one time. The Director will hold a staff training meeting where staff will view supervision videos. They will also receive training on how to talk to children about respecting their bodies. The Director will send LPA a copy of the agenda and attendance sheet via email by POC due date of 1/31/2020.
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Based on interviews with staff, parents and the child involved the staff members did not maintain visual supervision. This resulted in inappropriate interactions between children on the playground. This poses a potential health and safety risk to children in care.
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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: Tashima DanielTELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Grace CurtisTELEPHONE: (619) 767-2235
LICENSING EVALUATOR SIGNATURE:

DATE: 12/18/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2019
LIC9099 (FAS) - (06/04)
Page: 2 of 2