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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 376700693
Report Date: 10/26/2021
Date Signed: 10/26/2021 03:33:54 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
09/22/2021 and conducted by Evaluator Andrea Taylor
PUBLIC
COMPLAINT CONTROL NUMBER: 10-CC-20210922144030
FACILITY NAME:BOYS & GIRLS CLUBS OF GREATER SAN DIEGOFACILITY NUMBER:
376700693
ADMINISTRATOR:OLGA CAMACHOFACILITY TYPE:
850
ADDRESS:115 W. WOODWARD AVETELEPHONE:
(760) 746-3315
CITY:ESCONDIDOSTATE: CAZIP CODE:
92025
CAPACITY:53CENSUS: 19DATE:
10/26/2021
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Jisela Flores-Assistant DirectorTIME COMPLETED:
04:00 PM
ALLEGATION(S):
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Staff held children by the wrist, chin and yelled at children.
Staff did not assist child with their toileting needs in a timely manner
INVESTIGATION FINDINGS:
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The purpose of this inspection was to conduct a Complaint Investigation of the facility. On 9/22/21 a complaint was filed with the Licensing office. Census was taken in individual classrooms. The overall census observed was 19 preschool children and 6 staff members. A review of staff criminal clearance records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

During prior inspection on 9/29/21 LPA Taylor conducted interviews and obtained a current children’s roster.
During today's inspection LPAs interviews and reviewed files.

It is alleged a staff member sometimes holds children by the wrist in order to get the child to comply with the staff. It is also alleged the same staff member has held children's faces under the chin and stated look at me.
An allegation of child not being taken to the restroom right away when the child asked, some of these children have had accidents due to not being taken to the restroom right away.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Pauline BeschornerTELEPHONE: (951) 782-6641
LICENSING EVALUATOR NAME: Andrea TaylorTELEPHONE: (951) 782-4200
LICENSING EVALUATOR SIGNATURE:

DATE: 10/26/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2021
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 5
Control Number 10-CC-20210922144030
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: BOYS & GIRLS CLUBS OF GREATER SAN DIEGO
FACILITY NUMBER: 376700693
VISIT DATE: 10/26/2021
NARRATIVE
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Page 2

It was alleged two staff members yell at the children.

All pertinent persons were interviewed regarding the allegations of holding children by the wrist, holding children on the chin and yelling at the children. The statements of the adults interviewed and some of the children were consistent. They stated the staff member has been observed holding the children's arms or faces and the staff have yelled at the children.

Based on LPAs 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, 101223(a)(3) are being cited on the attached LIC 9099D.

An exit interview was completed. The report was reviewed and discussed. Appeal Rights and deficiencies were discussed. The facility representative was provided a copy of their appeal rights (LIC 9058 12/15) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Licensing office within 15 business days.

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 BeschornerTELEPHONE: (951) 782-6641
LICENSING EVALUATOR NAME: Andrea TaylorTELEPHONE: (951) 782-4200
LICENSING EVALUATOR SIGNATURE:

DATE: 10/26/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 10-CC-20210922144030
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: BOYS & GIRLS CLUBS OF GREATER SAN DIEGO
FACILITY NUMBER: 376700693
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/26/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/26/2021
Section Cited
CCR
101223(a)(3)
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Personal Rights: To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse or other actions of a punitive nature including but not limited to: interference with functions of daily living
including eating, sleeping or toileting; or ...
This requirement was not met as evidence
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Director stated she will have a meeting and train the staff on personal rights.
Director stated she will have the staff watch the Department's video on Personal Rights.

andrea.taylor@dss.ca.gov
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by the interview statements one staff member held children by the arms, held children by the chin, and two staff yell at the children. Some children taken to the restroom when asked to go and had a peeing accident.
This poses a 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: Pauline BeschornerTELEPHONE: (951) 782-6641
LICENSING EVALUATOR NAME: Andrea TaylorTELEPHONE: (951) 782-4200
LICENSING EVALUATOR SIGNATURE:

DATE: 10/26/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2021
LIC9099 (FAS) - (06/04)
Page: 5 of 5
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
09/22/2021 and conducted by Evaluator Andrea Taylor
PUBLIC
COMPLAINT CONTROL NUMBER: 10-CC-20210922144030

FACILITY NAME:BOYS & GIRLS CLUBS OF GREATER SAN DIEGOFACILITY NUMBER:
376700693
ADMINISTRATOR:OLGA CAMACHOFACILITY TYPE:
850
ADDRESS:115 W. WOODWARD AVETELEPHONE:
(760) 746-3315
CITY:ESCONDIDOSTATE: CAZIP CODE:
92025
CAPACITY:53CENSUS: 19DATE:
10/26/2021
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Jisela Flores-Assistant DirectorTIME COMPLETED:
04:00 PM
ALLEGATION(S):
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9
Staff did not supervise children allowing one child to bite another
Facility is out of ratio
INVESTIGATION FINDINGS:
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The purpose of this inspection was to conduct a Complaint Investigation of the facility. On 9/22/21 a complaint was filed with the Licensing office. Census was taken in individual classrooms. The overall census observed was 19 preschool children and 6 staff members. A review of staff criminal clearance records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

During prior inspection on 9/29/21 LPA Taylor conducted interviews and obtained a current children’s roster.
During today's inspection LPAs interviews and reviewed files.

It is alleged one child bit another child due to a lack of supervision. It is alleged the facility is sometimes out of ratio.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Pauline BeschornerTELEPHONE: (951) 782-6641
LICENSING EVALUATOR NAME: Andrea TaylorTELEPHONE: (951) 782-4200
LICENSING EVALUATOR SIGNATURE:

DATE: 10/26/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 10-CC-20210922144030
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: BOYS & GIRLS CLUBS OF GREATER SAN DIEGO
FACILITY NUMBER: 376700693
VISIT DATE: 10/26/2021
NARRATIVE
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Page 2

All pertinent persons were interviewed regarding the allegations of a lack of supervision and out of ratio were inconsistent.

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

An exit interview was completed. The report was reviewed and discussed. Appeal Rights and deficiencies were discussed. The facility representative was provided a copy of their appeal rights (LIC 9058 12/15) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Licensing office within 15 business days.
SUPERVISOR'S NAME: Pauline BeschornerTELEPHONE: (951) 782-6641
LICENSING EVALUATOR NAME: Andrea TaylorTELEPHONE: (951) 782-4200
LICENSING EVALUATOR SIGNATURE:

DATE: 10/26/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2021
LIC9099 (FAS) - (06/04)
Page: 4 of 5