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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 334810976
Report Date: 06/30/2023
Date Signed: 06/30/2023 09:57:13 AM

Substantiated


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
06/09/2023 and conducted by Evaluator Giselle Carbullido
PUBLIC
COMPLAINT CONTROL NUMBER: 09-CC-20230609130538
FACILITY NAME:FSA-ALVORD CDCFACILITY NUMBER:
334810976
ADMINISTRATOR:LISETTE PEREZFACILITY TYPE:
850
ADDRESS:8230 WELLS AVE.TELEPHONE:
(951) 637-5587
CITY:RIVERSIDESTATE: CAZIP CODE:
92503
CAPACITY:120CENSUS: 4DATE:
06/30/2023
UNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Veronica CortezTIME COMPLETED:
10:00 AM
ALLEGATION(S):
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Staff yelled at day care child.
Staff handled day care child in a rough manner.
Staff speaks to day care children in an inappropriate manner.
Staff makes inappropriate comments about day care children.
INVESTIGATION FINDINGS:
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On date and time listed above Licensing Program Analyst (LPA) Giselle Carbullido arrived at the facility to conduct an unannounced inspection to deliver the findings of the above allegations. On 06/12/2023, an initial inspection was completed, interviews were conducted, and records were obtained. During this inspection, LPA conducted additional interviews and discussed the findings of the above allegations with the Director, Veronica Cortez.
During this investigation, LPA interviewed all pertinent parties including six staff and two children and reviewed records.
It was alleged staff yelled at a daycare child. Pertinent parties reported observing a staff yell at children while making inappropriate comments and reporting this concern to management.

LPA’s review of records revealed concerns of staff yelling and inappropriate comments were reported to facility management in February 2023. Records reviewed indicate in April of 2023, two staff were spoken to regarding yelling at children in their performance improvement plans; however, their behavior had little
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Giselle Carbullido
LICENSING EVALUATOR SIGNATURE:

DATE: 06/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2023
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 4
Control Number 09-CC-20230609130538
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: FSA-ALVORD CDC
FACILITY NUMBER: 334810976
VISIT DATE: 06/30/2023
NARRATIVE
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to no improvement. Records indicated additional personnel discussions were held on 04/25/23 and 5/12/23.
It was alleged staff handled a day care child in a rough manner by grabbing the child’s legs and attempting to force shoes on the child during nap time.

Pertinent parties stated they witnessed a staff member become frustrated and attempt to put shoes on a child in an aggressive manner, resulting in the child falling backwards onto a mat after the child did not comply. Pertinent parties stated the facility policy is for children to keep their shoes on during nap time. Pertinent parties reported that children can put their own shoes on, but may require assistance.

It was alleged staff speaks to day care children in an inappropriate manner by imitating or mocking children.

Pertinent parties stated they have witnessed a staff member mocking or yelling at children needing help or imitating a crying child. Pertinent parties stated they have witnessed a staff member yell and state to children they will call their parents if the child did not stop crying.

LPA’s review of records revealed concerns of staff yelling and/or making inappropriate comments were reported to facility management in February 2023. Records reviewed indicate in April of 2023, two staff were spoken to regarding the use of positive communication in their performance improvement plans; however, their behavior had little to no improvement. Records indicated additional personnel discussions were held on 04/25/23 and 5/12/23. Formal disciplinary action was not taken until June 2023.

It was alleged staff makes inappropriate comments about day care children

Pertinent parties stated they have witnessed a staff member make comments regarding children’s clothing or character, about use of weapons, and not assisting a child along with gestures of shooting oneself in the head in the presence of children and other staff. Pertinent parties reported the inappropriate comments occurred on a daily/constant basis and have been reported to management.

LPA conducted a review of personnel records. Records review corroborate and address the yelling and inappropriate comments made by the staff member to or about the children.

SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Giselle Carbullido
LICENSING EVALUATOR SIGNATURE:

DATE: 06/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 09-CC-20230609130538
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: FSA-ALVORD CDC
FACILITY NUMBER: 334810976
VISIT DATE: 06/30/2023
NARRATIVE
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Based on LPA’s interviews conducted, and records reviewed, the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED per California Code of Regulations, Title 22, Division 12. See LIC9099D for cited deficiencies.

Appeal rights issued and discussed with Director 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 were provided to the Director Veronica Cortez. THIS REPORT MUST BE AVAILABLE TO THE PUBLIC UPON REQUEST FOR THREE YEARS

SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Giselle Carbullido
LICENSING EVALUATOR SIGNATURE:

DATE: 06/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 09-CC-20230609130538
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: FSA-ALVORD CDC
FACILITY NUMBER: 334810976
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/30/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/07/2023
Section Cited
CCR
101223(a)(1)
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101223(a)(1) Personal Rights: To be accorded dignity in his/her personal relationships with staff and other persons.

This requirement is not met as evidenced by:
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Facility will submit a written plan of action for ensuring children are accorded dignity in their relationships with staff including how facility will monitor concerns with employees, to the department by POC due date 07/07/23.
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Based on interviews conducted and records reviewed, facility did not accord the dignity of children in care in their personal relationships with staff. This is a potential risk to the health and safety of 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.
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Giselle Carbullido
LICENSING EVALUATOR SIGNATURE:

DATE: 06/30/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2023
LIC9099 (FAS) - (06/04)
Page: 4 of 4