376700600-12-8-2021-10-CC-PBER-C9XV6F-20211222150928

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 376700600
Report Date: 12/08/2021
Date Signed: 12/08/2021 01:08:23 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
11/30/2021 and conducted by Evaluator Andrea Taylor

PUBLIC

COMPLAINT CONTROL NUMBER: 10-CC-20211130093043

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: 29	DATE:	12/08/2021
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Marti Etedi-Acting Director		TIME COMPLETED:	01:30 PM

ALLEGATION(S):

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Child sustained multiple unexplained bruises

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPAs), Andrea Taylor and Linda Almaraz arrived at the facility to intiate the invesitgation into the above allegation. Upon arrival, LPA's met with Patricia Smith, Program Director and Marti Etedi, Assistant Director. LPA Taylor informed Ms. Smith and Ms. Etedi of the purpose of visit to investigate reported allegation listed above. LPAs toured the facility, took census.
LPAs Taylor and Almaraz interviewed staff, children and obtained records.

During interviews the staff and the children disclosed some of the children hit each other. There was no disclosure of any staff causing any bruises. The child in question did not disclose how or where they got the bruises. It cannot be determined how the child got the bruises.

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

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Pauline Beschorner	TELEPHONE: (951) 782-6641
LICENSING EVALUATOR NAME: Andrea Taylor	TELEPHONE: (951) 782-4200
LICENSING EVALUATOR SIGNATURE:	DATE: 12/08/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/08/2021

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-20211130093043

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: 12/08/2021

NARRATIVE

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In the areas that were evaluated, no deficiencies were observed of the California Code of Regulations, Title 22, Division 12 at the time of the visit.

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.

SUPERVISOR'S NAME: Pauline Beschorner	TELEPHONE: (951) 782-6641
LICENSING EVALUATOR NAME: Andrea Taylor	TELEPHONE: (951) 782-4200
LICENSING EVALUATOR SIGNATURE:	DATE: 12/08/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/08/2021

LIC9099 (FAS) - (06/04)

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