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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 334844660
Report Date: 12/21/2021
Date Signed: 12/21/2021 11:17:20 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
12/20/2021 and conducted by Evaluator Giselle Carbullido
PUBLIC
COMPLAINT CONTROL NUMBER: 09-CC-20211220141804
FACILITY NAME:KIDSPARKFACILITY NUMBER:
334844660
ADMINISTRATOR:JULIE MASONFACILITY TYPE:
840
ADDRESS:280 TELLER STREET #170TELEPHONE:
(951) 520-8900
CITY:CORONASTATE: CAZIP CODE:
92879
CAPACITY:30CENSUS: 9DATE:
12/21/2021
UNANNOUNCEDTIME BEGAN:
09:20 AM
MET WITH:Jeanette Pool, DirectorTIME COMPLETED:
11:20 AM
ALLEGATION(S):
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Facility is not following COVID-19 guidelines.
INVESTIGATION FINDINGS:
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On 12/21/2021 at 9:20AM Licensing Program Analyst (LPA) Giselle Carbullido conducted an unannounced visit regarding a complaint received concerning the above allegation. LPA was given access to the facility by Director Jeanette.Pool. LPA discussed purpose of visit, took census and toured the facility. LPA met with Ms. Pool to further discuss the complaint allegation(s) and deliver findings.
It was alleged the facility is not following California Covid-19 guidelines for masks by children.
At 9:30AM LPA observed 15 children not wearing face masks and not social distancing indoors. LPA conducted interviews with facility staff. Interviews revealed that staff considered face masks for children to be optional and required for staff. Staff interviews also acknowledged that some parents are divided on mask wearing and the facility makes attempts to meet their requests.

Based on evidence gathered and staff interviews the complaint allegation is substantiated, meaning the allegation is valid and the preponderance of the evidence standard has been met.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Giselle Carbullido
LICENSING EVALUATOR SIGNATURE:

DATE: 12/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2021
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 3
Control Number 09-CC-20211220141804
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: KIDSPARK
FACILITY NUMBER: 334844660
VISIT DATE: 12/21/2021
NARRATIVE
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LPA provided technical assistance to Licensee by reviewing and providing a copy of the current guidelines (as outlined by the California Department of Public Health) for family child care as follows:
1) California Department of Public Health
a. Guidance for Child Care Providers and Programs
i. Released on June 29, 2021
https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/Child-Care-Guidance.aspx#

2) California Department of Public Health


a. Guidance for Face Coverings
i. Released on July 28, 2021
https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/guidance-for-face-coverings.aspx

3) https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/Face-Coverings-QA.aspx



An exit interview was conducted, and appeal rights discussed. LPA provided Licensee with a copy of this report, appeal rights and notice of site visit. A copy of this report must be made available to the public upon request for three years.
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Giselle Carbullido
LICENSING EVALUATOR SIGNATURE:

DATE: 12/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 09-CC-20211220141804
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: KIDSPARK
FACILITY NUMBER: 334844660
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/21/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/22/2021
Section Cited
CCR
101223(a)(2)
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101223(a)(2) Personal Rights
2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs.

This requirement is not met as eveidenced by:
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Facility will post additonal signs at facility for mask wearing and implement CDPH face mask guidance including email notification to parents by POC due date 12/22/21. Facility will send pictures of addtional signs, letter to parents to LPA Carbullido at giselle.carbullido@dss.ca.gov.
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Based on LPA observation and staff interviews, the facility is not following COVID-19 best practices for mask wearing by children. This poses a potential health and safety risk for 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: 12/21/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2021
LIC9099 (FAS) - (06/04)
Page: 3 of 3