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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 334843376
Report Date: 02/21/2024
Date Signed: 02/21/2024 04:33:44 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
INLAND EMPIRE CHILD, 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
12/20/2023 and conducted by Evaluator Claudia Caywood
PUBLIC
COMPLAINT CONTROL NUMBER: 09-CC-20231220152304
FACILITY NAME:PENALOZA FAMILY CHILD CAREFACILITY NUMBER:
334843376
ADMINISTRATOR:PENALOZA,KELLY & JAIMEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(951) 818-1254
CITY:CORONASTATE: CAZIP CODE:
92883
CAPACITY:14CENSUS: 12DATE:
02/21/2024
UNANNOUNCEDTIME BEGAN:
03:01 PM
MET WITH:Kelly Penaloza, LicenseeTIME COMPLETED:
05:00 PM
ALLEGATION(S):
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Neglect/Lack of Supervision- Licensee is not meeting requirements of 80% at the facility
Ratio- Facility is out of ratio
Neglect/Lack of Supervision- Day care child sustained injury due to licensee neglect
Personal Rights- Licensee is not providing a safe environment for day care children
INVESTIGATION FINDINGS:
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On 2/21/2024, at 03:00 PM, Licensing Program Analyst (LPA) Claudia Caywood conducted an unannounced visit to the facility for the purpose of concluding a complaint investigation. LPA met with Licensee, Kelly Penaloza, regarding the above listed allegations, which were received on 12/20/2023. During the visit, LPA toured the facility, took census, and spoke to the Licensee regarding final findings.

Allegations: 1) Licensee is not meeting requirements of 80% at the facility. 2) Facility is out of ratio. 3) Day-care child sustained injury due to licensee neglect. 4) Licensee is not providing a safe environment for day-care children

During the investigation, LPA conducted interviews with all pertinent parties, including staff, reviewed children files, and toured the facility.

(Cont.)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Claudia Caywood
LICENSING EVALUATOR SIGNATURE:

DATE: 02/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2024
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 4
Control Number 09-CC-20231220152304
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
INLAND EMPIRE CHILD, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: PENALOZA FAMILY CHILD CARE
FACILITY NUMBER: 334843376
VISIT DATE: 02/21/2024
NARRATIVE
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On 12/19/23, a staff member was alone, without the licensee present or any other staff/volunteer, during the entire operating hours 8:40 am to 5:00 pm. While alone, the staff member was caring for 13 children alone, with four of the children being under the infant age of 24 months. Interviews revealed the staff member was feeling overwhelmed for having to care for so many children, and staff did not notice a child bite a sleeping child on their cheek.

While touring the facility, LPA observed many small plastic, wooden, and metal toys spread across the facility floor which could potentially result in a choking accident. LPA took photos of the small toys and brought it to the licensee's attention.

All of these are violations of Title 22 regulation codes 102417(a), Operation of a Family Child Care Home; 102416.5 (e), Staffing, Ratio, and Capacity; and 102423 (a) (2), Personal Rights.

Based on LPAs interviews and own observation, the licensee did not meet requirements of being at the facility 80% of each day, facility was operating out of ratio, a day-care child sustained an injury due to neglect, and the licensee did not provide a safe environment for day-care children.

The preponderance of evidence standard has been met; therefore, the above allegations are found to be SUBSTANTIATED. California Code of Regulations (Title 22, Division 12) are cited on the attached LIC9099D.
Licensee was provided the Acknowledgment of Receipt of Licensing Reports (LIC 9224) form. Licensee understands a copy of this report and the LIC 9224 form shall be provided to parents/guardians of children currently enrolled and parents/guardians of children who are enrolled 12 months from the date of this report.


Appeal rights issued and discussed with Licensee, Kelly Penaloza, and their signature on this form acknowledges receipt of these rights.

An exit interview was conducted, and a copy of this report was provided to Licensee, Kelly Penaloza.

THIS REPORT MUST BE AVAILABLE TO THE PUBLIC FOR THREE YEARS.
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Claudia Caywood
LICENSING EVALUATOR SIGNATURE:

DATE: 02/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Citations on this Visit Report are Under Appeal!

Control Number 09-CC-20231220152304
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
INLAND EMPIRE CHILD, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: PENALOZA FAMILY CHILD CARE
FACILITY NUMBER: 334843376
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/21/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Under Appeal
Type A
02/22/2024
Section Cited
CCR
102417(a)
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102417(a) Operation of a Family Child Care Home: The licensee shall be present in the home... ensure...When circumstances require the licensee to be temporarily absent... Temporary absences shall not exceed 20 percent of the hours... per day. This requirement was not met as evidenced by:
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Licensee agreed to provide a letter of understanding regarding section cited 102417 (a) and signed off by all staff including themselves. License will send the letter to the department by the POC due date of 1/22/2024 and express the importance of complying with the regulation.
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Based on LPAs interview with pertinent individuals, The licensee was absent more than 20% of the day on 12/19/23. This is an immediate risk to the health and safety of children in care.
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Type B
CCR
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CREATED IN ERROR
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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: Claudia Caywood
LICENSING EVALUATOR SIGNATURE:

DATE: 02/21/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Citations on this Visit Report are Under Appeal!

Control Number 09-CC-20231220152304
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
INLAND EMPIRE CHILD, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: PENALOZA FAMILY CHILD CARE
FACILITY NUMBER: 334843376
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/21/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Under Appeal
Type B
03/01/2024
Section Cited
CCR
102423(a)(2)
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102423(a)(2) Personal Rights: (a) Each child receiving services from a family child care home shall have certain rights...These rights include, but are not limited to, the following: (2) To receive safe, healthful, and comfortable accommodations, furnishings, and equipment. This requirement was not met as evidenced by:

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Licensee agreed to eliminate small toys that are potentially dangerous to infants. They will do this by throwing them out and going forward they will be looking to incorporate toys that are age appropriate for all ages of facility children.
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Based on LPA observations and interview with pertinent individuals the licensee did not provide a safe environment. During interview inspection, LPA observed many small toys on the facility floor where infants crawl. This is a potential risk to the health and safety of children in care.
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Under Appeal
Type B
03/01/2024
Section Cited
CCR
102416.5(e)
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102416.5(e) Staffing, Ratio, Capacity: If no assistant provider is present at a Large Family Child Care Home... licensee shall comply with the capacity requirements for a Small Family Child Care Home...This requirement was not met as evidenced by:
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Licenseee agreed to train all employees of ratio and capacity regulations section 102416.5 (e) and will have a letter of understanding signed by themselves and all staff
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Based on LPA's interviews with pertinent individuals the licensee did not comply with the capacity requirement of a Large Family Child Care Home and was over capacity for an entire day. 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: Claudia Caywood
LICENSING EVALUATOR SIGNATURE:

DATE: 02/21/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2024
LIC9099 (FAS) - (06/04)
Page: 4 of 4