<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 376700061
Report Date: 09/24/2021
Date Signed: 09/29/2021 12:53:49 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
06/11/2021 and conducted by Evaluator Otsanya Cameron
PUBLIC
COMPLAINT CONTROL NUMBER: 10-CC-20210611160504
FACILITY NAME:MAAC PROJECT HEAD START NORTH COASTFACILITY NUMBER:
376700061
ADMINISTRATOR:TRACEY ASTORGAFACILITY TYPE:
850
ADDRESS:1501 KELLY STREETTELEPHONE:
(760) 966-7135
CITY:OCEANSIDESTATE: CAZIP CODE:
92054
CAPACITY:60CENSUS: 16DATE:
09/24/2021
UNANNOUNCEDTIME BEGAN:
12:11 PM
MET WITH: Director Patricia VillicanaTIME COMPLETED:
02:36 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Provider inappropriately disciplined day care child
Parent was not notified of incident.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Otsanya Cameron arrived at the facility to deliver findings for the above allegations. LPA met with Director Patricia Villicana, toured the facility, and confirmed census of 16 children. Interviews were also held on this date. *** This is an Amended Report***

It is alleged that, provider inappropriately disciplined day care child. It is alleged that parent was not notified of incident.
During this investigation, LPA reviewed video footage provided by the center. The video footage was viewed from several angles. Based on observations of the video footage, LPA observed Staff 1 (S1) to grab child 1 (C1) by the arm. In addition, LPA observed C1 approach S1 to show the markings left by S1 when S1 grabbed C1 by the arm. S1 then consoled C1 as C1 was crying about markings left by S1. In addition, LPA reviewed facility records. A review of records indicated an "ouch report" was not completed by staff nor did staff verbally notify parent of an injury to C1. Based on interviews with pertinent witnesses and record review, the injury was not reported to the parent.

See Lic 9099C for continuance of this report
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Pauline BeschornerTELEPHONE: (951) 782-6641
LICENSING EVALUATOR NAME: Otsanya CameronTELEPHONE: (951) 970-1388
LICENSING EVALUATOR SIGNATURE:

DATE: 09/24/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2021
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 4
Control Number 10-CC-20210611160504
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: MAAC PROJECT HEAD START NORTH COAST
FACILITY NUMBER: 376700061
VISIT DATE: 09/24/2021
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Based on observations of the video footage, record review and interviews the preponderance standard has been met. Therefore, the above allegations are found to be SUBSTANTIATED, California Code of Regulations Title 22, citations are being cited on the attached LIC 9099D.

An Investigation completed with Oceanside Police Department revealed criminal action will be taken and report was filed with district Attorney’s office.

An exit interview was conducted, and a copy of this report was reviewed with and provided to Director Patricia Villicana, whose signature on this form confirm receipt of the above-mentioned documents.
SUPERVISOR'S NAME: Pauline BeschornerTELEPHONE: (951) 782-6641
LICENSING EVALUATOR NAME: Otsanya CameronTELEPHONE: (951) 970-1388
LICENSING EVALUATOR SIGNATURE:

DATE: 09/24/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 10-CC-20210611160504
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: MAAC PROJECT HEAD START NORTH COAST
FACILITY NUMBER: 376700061
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/24/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/27/2021
Section Cited
HSC
101223(a)(3)
1
2
3
4
5
6
7
101223(a)(3) Personal Rights. (a) The licensee shall ensure that each child is accorded the following (3) Each child shall be free from corporal/unusual punishment, humiliation, intimidation, ridicule, coercion...or other actions of a punitive nature... This requirement was not met as evidenced by:


1
2
3
4
5
6
7
Director will conduct a training with staff on personal rights.

Director will submit proof of the training to the dept by COB 9/27/21
A training on Positive Descriptive acknowledgement and redirecting behavior was conducted 8/13/21
8
9
10
11
12
13
14
 Based on observations of the video footage, record review and interviews The licensee did not ensure the personal rights of a child in care was met;
This is an immediate risk to the health and safety of children in care.
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: Pauline BeschornerTELEPHONE: (951) 782-6641
LICENSING EVALUATOR NAME: Otsanya CameronTELEPHONE: (951) 970-1388
LICENSING EVALUATOR SIGNATURE:

DATE: 09/24/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2021
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 10-CC-20210611160504
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: MAAC PROJECT HEAD START NORTH COAST
FACILITY NUMBER: 376700061
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/24/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/30/2021
Section Cited
HSC
101226(a)(2)
1
2
3
4
5
6
7
101226(a)(2) Health-Related Services
2) In the case of less serious injuries including, but not limited to, minor cuts, scratches...requiring assessment and/or administration of first aid by staff, the licensee shall document the injury...and notify the child's authorized representative of the nature of the injury when the child is picked up from the center.
1
2
3
4
5
6
7
 Director states will conduct training on how to document and deliver ouch reports following the policy.
Director will submit proof of training to the department by 10/1/21.
8
9
10
11
12
13
14
This requirement was not met as evidenced by:
Based on record review, Facility director did not ensure the authorized representative was notified of an injury.
THis poses a potential risk to children in care.
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: Pauline BeschornerTELEPHONE: (951) 782-6641
LICENSING EVALUATOR NAME: Otsanya CameronTELEPHONE: (951) 970-1388
LICENSING EVALUATOR SIGNATURE:

DATE: 09/24/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2021
LIC9099 (FAS) - (06/04)
Page: 4 of 4