376700600-3-9-2022-10-CC-PBER-CCHT3A-20220314142201

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 376700600
Report Date: 03/09/2022
Date Signed: 03/09/2022 10:26:53 AM

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
12/21/2021 and conducted by Evaluator Anastasia Flores

PUBLIC

COMPLAINT CONTROL NUMBER: 10-CC-20211221151044

FACILITY NAME:	EES-DAVID & JILLIAN GILMOUR EARLY EDUCATION		FACILITY NUMBER:	376700600
ADMINISTRATOR:	JESSICA DORN		FACILITY TYPE:	850
ADDRESS:	735 AVENIDA DE BENITO JUAREZ		TELEPHONE:	(760) 639-4170
CITY:	VISTA	STATE: CA	ZIP CODE:	92083
CAPACITY:	102	CENSUS: 41	DATE:	03/09/2022
		UNANNOUNCED	TIME BEGAN:	09:37 AM
MET WITH:	Courtney Gay		TIME COMPLETED:	10:39 AM

ALLEGATION(S):

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Lack of supervision resulting in child sustaining unexplained injuries while in care

INVESTIGATION FINDINGS:

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On March 09 2022, at 9:37 AM, Licensing Program Analyst (LPA) Anastasia Flores arrived to EES David & Jillian Gilmour Early Education and met with Site Director, Courtney Gay, for the purpose of delivering the findings of the above allegation. On December 27, 2021 at 9:30 AM, LPA Andrea Taylor conducted a safety inspection of the facility and no immediate health and safety risks were noted. Copies of child #1 (C1) plan of action and parent contact form, “ouchie report” dated 12/20/21 were obtained. Interviews were conducted with five staff members and one child.
On December 21, 2022 this agency received a complaint allegation C1 was injured due to lack of supervision. Confidential interviews disclosed C1 was running around the center of the classroom and was redirected by staff #3 (S3) to stop running to avoid injury. Confidential interviews disclosed that there were four teachers in the classroom and when C1 fell none of the teachers saw or heard the fall. Confidential records reviewed revealed that when C1 has disruptive behaviors, staff are to intervene, position themselves between doors, gates, and redirect C1 to activities that he enjoys. Interview with Site
(continued on next page)

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Pauline Beschorner	TELEPHONE: (951) 782-6641
LICENSING EVALUATOR NAME: Anastasia Flores	TELEPHONE: (951) 533-2031
LICENSING EVALUATOR SIGNATURE:	DATE: 03/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2022

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-20211221151044

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: EES-DAVID & JILLIAN GILMOUR EARLY EDUCATION	FACILITY NUMBER: 376700600
	VISIT DATE: 03/09/2022

NARRATIVE

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Director disclosed that the child care center (CCC) are making plans to assist the staff in the CCC with trainings on care and supervision of children, and changes to the classroom census to better meet the needs of the children in care. Confidential interviews disclosed that staff saw C1 running in the classroom resulting in C1 being injured on the middle of the head and lower lip. The staff were unable to meet the child’s needs due to failing to prevent the child from running in the class and falling.
Based on LPA’s observation, interviews and record review the preponderance of evidence has been met and the allegation that due to lack of supervision C1 received injury while in care is substantiated. The facility is being cited with Title 22, Division 12, chapter 1, article 06, regulation; 101229; Responsibility for providing care and supervision which poses an immediate threat to children in care.
An exit interview is conducted, copy of report, Confidential List (LIC811), 9099D and appeal rights are handed to Courtney Gay. An exit interview was completed. The report was reviewed and discussed. Appeal Rights and deficiencies were discussed.

The facility representative was informed that the “Notice of Site Visit” must be posted for 30 consecutive days. Failure to post will result in Civil Penalties of $100.00. The “Notice of Site Visit” must be posted on or adjacent to the door. Failure to post Type A reports for 30 days will result in a Civil Penalty of $100.00
If the facility receives a Type A violations, the licensee shall post and provide copies of the report to parents/guardians of the children in care at the facility by the next business day, and shall provide to the parents/guardians of children newly enrolled at the facility during the next 12 months. In addition, the licensee shall immediately post upon receipt the Proof of Correction for 30 consecutive days and provide a copy to current and enrolling parents. The licensee is to keep Acknowledgement Receipt (LIC 9224) signed by parents in each child’s file.

SUPERVISOR'S NAME: Pauline Beschorner	TELEPHONE: (951) 782-6641
LICENSING EVALUATOR NAME: Anastasia Flores	TELEPHONE: (951) 533-2031
LICENSING EVALUATOR SIGNATURE:	DATE: 03/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2022

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 10-CC-20211221151044

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: EES-DAVID & JILLIAN GILMOUR EARLY EDUCATION	FACILITY NUMBER: 376700600
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/09/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 03/10/2022 Section Cited CCR 101229(a)	1 2 3 4 5 6 7	101229(a) Responsibility for Providing Care and Supervision the licensee shall provide care and supervision as necessary to meet the children’s needs. This was not met as evidenced by…	1 2 3 4 5 6 7	Courtney Gay informed LPA Flores that the school is working with the parents of C1 and how to best meet his needs. The school is closely monitoring C1 with his surroundings in the classroom, offerering positive reinforcements (PDA's). The education coordinator is observing C1 with and trying to see if the behavior plan needs to be updated. The facility had trauma informed care training for the staff on 02/18/22 to assist the teachers in knowing how better to meett the needs of the chidlren in their care.
	8 9 10 11 12 13 14	Based on interviews and record review, staff were unable to meet the child’s needs due to failing to prevent the child from running in the class resulting in injury. This poses an immediate health and safety 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 Beschorner	TELEPHONE: (951) 782-6641
LICENSING EVALUATOR NAME: Anastasia Flores	TELEPHONE: (951) 533-2031
LICENSING EVALUATOR SIGNATURE:	DATE: 03/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2022

LIC9099 (FAS) - (06/04)

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