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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 334807214
Report Date: 09/14/2022
Date Signed: 09/14/2022 09:07:38 AM

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 STREET, STE 700
RIVERSIDE, CA 92501
This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/18/2022 and conducted by Evaluator Sumayya Habeebulla
PUBLIC
COMPLAINT CONTROL NUMBER: 10-CC-20220818120015
FACILITY NAME:JAN PETERSON CHILD DAY CARE CENTERFACILITY NUMBER:
334807214
ADMINISTRATOR:LINDA BEDNARFACILITY TYPE:
850
ADDRESS:26895 BRODIAEA AVENUETELEPHONE:
(951) 601-9200
CITY:MORENO VALLEYSTATE: CAZIP CODE:
92555
CAPACITY:92CENSUS: 64DATE:
09/14/2022
UNANNOUNCEDTIME BEGAN:
08:40 AM
MET WITH:Victoria DeLaVegaTIME COMPLETED:
09:15 AM
ALLEGATION(S):
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- Director speaks harsh to staff in front of daycare children
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Sumayya Habeebulla arrived at the facility for the purpose of conducting a subsequent complaint visit, which includes concluding the investigation and delivering the investigation findings regarding the compliant investigation initiated on 08/23/22. LPA met with Assistant Director Victoria DeLaVega and discussed the above allegation.

On 08/23/22 LPA Habeebulla conducted interviews with 7 staff members, including children and the Director, all of whom are pertinent to this investigation. Along with interviews, the investigation revealed that:


SEE LIC 9099C for CONTINUATION
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Sumayya Habeebulla
LICENSING EVALUATOR SIGNATURE:

DATE: 09/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2022
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 10-CC-20220818120015
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: JAN PETERSON CHILD DAY CARE CENTER
FACILITY NUMBER: 334807214
VISIT DATE: 09/14/2022
NARRATIVE
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There is an allegation that the Director speaks harshly to staff in front of daycare children. During the investigation, LPA was unable to collect pertinent information that would corroborate allegation that the Director has spoken harshly to staff in front of the childcare children. Based on the information obtained through interviews of staff and children, no one has observed any disrespectful or harsh tones of interaction between staff in the presence of the Childcare children. As per staff and the Director, parents have not approached them bringing this matter to their attention.

From the information received by interviews with staff, and facility documents the above allegation cannot be verified. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the allegation did or did not occur, therefore, the allegation is UNSUBSTANTIATED

An exit interview was conducted, a Notice of Site Visit posted, and a copy of this report was provided to the facility on this date and time.
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Sumayya Habeebulla
LICENSING EVALUATOR SIGNATURE:

DATE: 09/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2