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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 330900318
Report Date: 03/20/2024
Date Signed: 03/20/2024 02:14:50 PM

Unsubstantiated


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 ST., SUITE 700
RIVERSIDE, CA 92501
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/06/2024 and conducted by Evaluator Giselle Carbullido
PUBLIC
COMPLAINT CONTROL NUMBER: 09-CC-20240306092938
FACILITY NAME:FIRST CHRISTIAN CHURCH PRESCHOOLFACILITY NUMBER:
330900318
ADMINISTRATOR:LISA VILLAFACILITY TYPE:
850
ADDRESS:4055 JURUPA AVENUETELEPHONE:
(951) 683-5780
CITY:RIVERSIDESTATE: CAZIP CODE:
92506
CAPACITY:50CENSUS: 21DATE:
03/20/2024
UNANNOUNCEDTIME BEGAN:
01:50 PM
MET WITH:Elizabeth Martinez, DirectorTIME COMPLETED:
02:20 PM
ALLEGATION(S):
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Day care child sustained an unexplained injury while in care.
INVESTIGATION FINDINGS:
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On the date and time listed above, Licensing Program Analyst (LPA) Giselle Carbullido arrived at the facility to investigate the above complaint received on 03/06/2024. An initial visit was conducted on 03/07/24, at which time LPA conducted interviews and reviewed records. LPA was given access to the facility by the Director, Elizabeth Martinez. LPA discussed purpose of visit, took census, and toured the facility. LPA met with the Director to further discuss the complaint allegations and deliver findings.
It was alleged a child sustained an unexplained injury while in care. During the investigation, LPA interviewed all pertinent parties, including facility staff.
Pertinent party interviews denied any mishandling of a child, or observations of abrasions/injuries while in care. Additional interviews noted light redness where pull up pants might rub on the body and that observation of the mark was made approximately 1-2 hours after the child left the daycare.
LPA reviewed the following records: Toileting and sign in/out logs and photos. Diaper change and sign in/out logs did not note any concerns for injury or abrasion. Photos obtained showed redness, redness around raised scaly bumps, light scabbing the next day and that child had long fingernails.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Giselle Carbullido
LICENSING EVALUATOR SIGNATURE:

DATE: 03/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2024
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 2
Control Number 09-CC-20240306092938
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 ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: FIRST CHRISTIAN CHURCH PRESCHOOL
FACILITY NUMBER: 330900318
VISIT DATE: 03/20/2024
NARRATIVE
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Due to conflicting information obtained from interviews and records from what was reported, LPA is unable to definitively identify time or how incident occurred. 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.
Appeal rights issued and discussed with licensee and their signature on this form acknowledges receipt of these rights. An exit interview was conducted, a copy of this report and Notice of Site Visit was provided to Director, Elizabeth Martinez. THIS REPORT MUST BE MADE AVAILABLE TO THE PUBLIC UPON REQUEST FOR THREE YEARS.
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Giselle Carbullido
LICENSING EVALUATOR SIGNATURE:

DATE: 03/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2