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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 334807214
Report Date: 08/17/2023
Date Signed: 08/17/2023 01:45:46 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 STREET, STE 700
RIVERSIDE, CA 92501
This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/05/2023 and conducted by Evaluator Sumayya Habeebulla
COMPLAINT CONTROL NUMBER: 10-CC-20230705160318
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: 61DATE:
08/17/2023
UNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Linda BednarTIME COMPLETED:
01:00 PM
ALLEGATION(S):
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5
6
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8
9
- unqualified teacher left unsupervised with children
- unqualified teacher sprayed kids in the face and laughed about it
INVESTIGATION FINDINGS:
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5
6
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9
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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 07/05/23. LPA met with Director Linda Bednar and discussed the above allegations.

On 07/26/23 LPA Habeebulla conducted interviews with 4 staff members, on 08/11/23 interviewed 1 staff member, and on this date interviewed 4 children who all 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: 08/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2023
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-20230705160318
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: 08/17/2023
NARRATIVE
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There is an allegation that an unqualified teacher is left unsupervised with children. Upon reviewing pertinent documents and per interviews conducted, the facility S6 was confirmed to be a floater/aid/helper and has not been left alone with the children. As per the documents, S6 is qualified to be an aide and is working towards becoming a fully qualified teacher. Interviews revealed there is always a fully qualified staff present with S6. During investigation and the facility visits conducted, LPA has not observed S6 supervising children alone.

The second allegation is an unqualified teacher sprayed kids in the face and laughed about it. The interviews revealed that each classroom has set days and hours for water play and no staff has witnessed any personal rights violation of a child being sprayed on the face with water in a disrespectful manner. In addition, LPA conducted interviews with children and there was no disclosure of any personal rights violation.

From the information received by interviews with staff, and facility documents the above allegations cannot be verified. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the allegations did or did not occur, therefore, the allegations are 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: 08/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2