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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 376700122
Report Date: 04/24/2024
Date Signed: 04/24/2024 02:38:48 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SE CC RO, 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
12/19/2023 and conducted by Evaluator William M Chancellor Jr.
PUBLIC
COMPLAINT CONTROL NUMBER: 10-CC-20231219123114
FACILITY NAME:CHILDREN'S PARADISE INC. - MELROSEFACILITY NUMBER:
376700122
ADMINISTRATOR:SHAINA CORMIERFACILITY TYPE:
850
ADDRESS:145 N, MELROSE DR. STE 100TELEPHONE:
(760) 724-5600
CITY:VISTASTATE: CAZIP CODE:
92083
CAPACITY:126CENSUS: 87DATE:
04/24/2024
UNANNOUNCEDTIME BEGAN:
01:31 PM
MET WITH:Shaina CormierTIME COMPLETED:
02:00 PM
ALLEGATION(S):
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Staff left day care child unattended on the playground
INVESTIGATION FINDINGS:
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On date and time listed, Licensing Program Analyst’s (LPA’s ) William Chancellor and Anastasia Flores arrived unannounced to Children’s Paradise- Melrose (CCC) and met with Shaina Cormier, Director (DIR) to deliver the investigative findings regarding on allegation listed above.

On December 19, 2023, the Department received the allegation that staff left day care child unattended on the playground.

On December 21, 2023, LPA Chancellor initiated a 10-Day complaint investigation and conducted a health and safety inspection of the facility where no immediate concerns were noted. The investigation was conducted by Ernestina Bellucco Special Investigator of the Community Care Licensing Investigation Branch (IB). The following pertinent documents were obtained: facility records, such as children’s roster, child files, staff files, reports and medical records for C1.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: William M Chancellor Jr.
LICENSING EVALUATOR SIGNATURE:

DATE: 04/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2024
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 5
Control Number 10-CC-20231219123114
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: CHILDREN'S PARADISE INC. - MELROSE
FACILITY NUMBER: 376700122
VISIT DATE: 04/24/2024
NARRATIVE
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The investigation by IB Bellucco did provide enough evidence to support the allegation that staff left day care child unattended on the playground.
During the course of the investigation, CCC self reported and submitted an Unusual Incident Report (UIR) regarding, C1 being accidentally left outside on the playground during a transition back into the classroom. An incident report was also provided to the parent, documenting that C1 was left unsupervised on the playground. CCC also provided four of four performance corrective notices to employees involved in leaving C1 on the playground. Documented in the performance corrective notices, Teacher received active supervision training by site director on 12/19/23 to improve name to face policy and to always ensure supervision. Interviews additionally revealed that C1 was left unsupervised on the playground and when parent arrived in the classroom, parent noticed C1 was not present. Staff then went to the playground and located C1.

Based on the investigative evidence gathered by Special Investigator, Ernestina Bellucco, confidential interviews, and record review the preponderance of evidence standard has been met, therefore, the allegation that staff left day care child unattended on the playground is substantiated. The facility is being cited for Title 22, division 12, chapter 1, article 06; section 101229(a)(1) Responsibility for Providing Care and Supervision. Which poses a potential risk to children in care. See 809-D for cited deficiencies.

An exit interview was conducted, a copy of this report, appeal rights and Notice of Site Visit were provided to Shaina Cormier. Notice of Site Visit must remain posted for 30 consecutive days.
SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: William M Chancellor Jr.
LICENSING EVALUATOR SIGNATURE:

DATE: 04/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 10-CC-20231219123114
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: CHILDREN'S PARADISE INC. - MELROSE
FACILITY NUMBER: 376700122
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/24/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/03/2024
Section Cited
CCR
101229(a)(1)
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Responsibility for Providing Care and Supervision:The licensee shall provide care and supervision as necessary to meet the children's needs. No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation. This requirement was not met as evidenced by …
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Center immediately provided trainings to all staff involved to improve name to face policy and ensure complete supervision is being maintained during transitions. Shadowing by Director was also conducted to ensure accuracy of name to face transitions.
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Based on confidential interviews and record review, C1 was left unsupervised on the playground during a transition inside. Parent arrived in classroom to pick up child and child was found on the playground with complete absence of supervision. This poses a potential 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.
SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: William M Chancellor Jr.
LICENSING EVALUATOR SIGNATURE:

DATE: 04/24/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SE CC RO, 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
12/19/2023 and conducted by Evaluator William M Chancellor Jr.
PUBLIC
COMPLAINT CONTROL NUMBER: 10-CC-20231219123114

FACILITY NAME:CHILDREN'S PARADISE INC. - MELROSEFACILITY NUMBER:
376700122
ADMINISTRATOR:SHAINA CORMIERFACILITY TYPE:
850
ADDRESS:145 N, MELROSE DR. STE 100TELEPHONE:
(760) 724-5600
CITY:VISTASTATE: CAZIP CODE:
92083
CAPACITY:126CENSUS: 87DATE:
04/24/2024
UNANNOUNCEDTIME BEGAN:
01:31 PM
MET WITH:Shaina CormierTIME COMPLETED:
02:00 PM
ALLEGATION(S):
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9
Day care child sustained an unexplained fracture while in care
INVESTIGATION FINDINGS:
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On date and time listed, Licensing Program Analyst’s (LPA’s ) William Chancellor and Anastasia Flores arrived unannounced to Children’s Paradise- Melrose (CCC) and met with Shaina Cormier, Director (DIR) to deliver the investigative findings regarding on allegation listed above.

On December 19, 2023, a complaint allegation was reported to Community Care Licensing (CCL) stating that Child #1 (C1) sustained an unexplained fracture while in care. C1 was taken to the hospital where C1 was diagnosed with a supracondylar fracture. The investigation was conducted by Ernestina Bellucco, Special Investigator of the Community Care Licensing Investigation Branch (IB).
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: William M Chancellor Jr.
LICENSING EVALUATOR SIGNATURE:

DATE: 04/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 10-CC-20231219123114
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: CHILDREN'S PARADISE INC. - MELROSE
FACILITY NUMBER: 376700122
VISIT DATE: 04/24/2024
NARRATIVE
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Five of five interviews revealed that on November 20, 2023, C1 was, “not acting like themselves and upon entering the childcare was noticed by teachers to be whining.” Throughout the day childcare staff noticed that C1’s behavior progressively worsened as they continued to whimper and would stay close to the teachers and aides. Throughout the day, C1 did not want to actively participate in any daily tasks or activities. Parent of C1 was contacted by staff three times that day and would update parent of C1’s condition. Parent was made aware that C1 was progressively feeling worse and was holding their arm. Parent then informed the staff that C1 was tired and would be fine.

Based on the investigative evidence gathered by Special Investigator, Ernestina Bellucco, the allegation that day care child sustained an unexplained fracture while in care, may have occurred, however is not supported, or proven by evidence. Therefore, the allegation is unsubstantiated at this time.

An exit interview was conducted, a copy of this report, appeal rights and Notice of Site Visit were provided to Shaina Cormier. Notice of Site Visit must remain posted for 30 consecutive days.
SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: William M Chancellor Jr.
LICENSING EVALUATOR SIGNATURE:

DATE: 04/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2024
LIC9099 (FAS) - (06/04)
Page: 5 of 5