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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334840812
Report Date: 04/30/2024
Date Signed: 04/30/2024 01:57:00 PM

Document Has Been Signed on 04/30/2024 01:57 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:MORRIS FAMILY CHILD CAREFACILITY NUMBER:
334840812
ADMINISTRATOR/
DIRECTOR:		MORRIS, DAWNFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(951) 924-5498
CITY:MORENO VALLEYSTATE: CAZIP CODE:
92551
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 5DATE:
04/30/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:03 PM
MET WITH:Dawn Morris, LicenseeTIME VISIT/
INSPECTION COMPLETED:
01:35 PM
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Licensing Program Analyst (LPA) Jesse Gardner conducted an unannounced Case Management inspection to address information revealed during an investigation. Refer to 10-CC-20240424165213. LPA met with Licensee Dawn Morris, and explained the purpose of the visit, and was allowed entry into the facility. LPA then toured the facility inside and out.

During the course of the investigation, it was found that on 4/22/24, two uncleared staff were counted on to be responsible to provide care and supervision to children in the facility. Staff One (S1) was said by the Licensee to live at the facility for approximately 2 weeks. Staff Two (S2) was said by the Licensee to have worked at the facility for approximately 6 months with initial clearance request paperwork signed in 7/2023. S1 did not have a clearance letter provided by the Department of Justice. Record review revealed that both S1, and S2 were found to not have a cleared background through Guardian.

Based on information gathered, the Licensee did not abide by Title 22 regulations; thus, a citation, and (2) immediate Civil Penalties were issued.

When a facility receives a Type A violation, 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.

An exit interview was held with Licensee Dawn Morris. A copy of this report was discussed with and issued, along with copies of the LIC 811 (Confidential Names List), LIC 809D, LIC 421BG, and Appeal Rights. A Notice of Site visit was also issued. This report shall be public record for three years.

SUPERVISORS NAME: Deborah Mullen
LICENSING EVALUATOR NAME: Jesse Gardner
LICENSING EVALUATOR SIGNATURE: DATE: 04/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/30/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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Document Has Been Signed on 04/30/2024 01:57 PM - It Cannot Be Edited


Created By: Jesse Gardner On 04/30/2024 at 12:37 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: MORRIS FAMILY CHILD CARE
FACILITY NUMBER: 334840812

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/30/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/01/2024
Section Cited
CCR
102370(d)(1)

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(d) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing, or volunteering in a licensed facility:(1) Obtain a California clearance or a criminal record exemption as required by the Department or...This requirement was not being met as evidenced by:
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Licensee states that they will conduct in-service training and provide proof of such to LPA by POC date. Additionally, Licensee will submit S1's clearance once received to CCL. Licensee states that S2 no longer works for the facility.
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Based on staff interview, and record review, S1, and S2 did not have a clearance to provide care and supervision to children. This is an immediate health and safety or personal rights 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:Deborah Mullen
LICENSING EVALUATOR NAME:Jesse Gardner
LICENSING EVALUATOR SIGNATURE:
DATE: 04/30/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/30/2024


LIC809 (FAS) - (06/04)
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