334846105-11-9-2023-09-CC-AROS-CY343H-20231129174445

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 334846105
Report Date: 11/09/2023
Date Signed: 11/09/2023 02:00:42 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
09/01/2023 and conducted by Evaluator Claudia Caywood

PUBLIC

COMPLAINT CONTROL NUMBER: 09-CC-20230901095730

FACILITY NAME:	HAPPY WORLD PRESCHOOL		FACILITY NUMBER:	334846105
ADMINISTRATOR:	TAPIA, ARACELI		FACILITY TYPE:	850
ADDRESS:	2641 GREEN RIVER RD STE 101		TELEPHONE:	(562) 219-1014
CITY:	CORONA	STATE: CA	ZIP CODE:	92882
CAPACITY:	34	CENSUS: 20	DATE:	11/09/2023
		UNANNOUNCED	TIME BEGAN:	09:39 AM
MET WITH:	Licensee, Manzar Farooqui		TIME COMPLETED:	02:20 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Qualificiation: Excluded adult present
Reporting Requirements: Failure to provide licensing forms

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

On 11/09/2023 at 09:10 AM, Licensing Program Analysts (LPAs) Claudia Caywood and Patricia Berry made an unannounced visit to the facility for the purpose of concluding a complaint investigation. LPA's met with Licensee, Manzar Farooqui regarding the above listed allegation, which was received on 09/01/2023. LPA's toured the facility, took census, and spoke to the Director regarding the complaint allegations and delivered findings.

The following was alleged: 1) Excluded adult present 2) Reporting Requirements: Failure to provide licensing forms.

A Decision and Order became effective on May 26, 2022, for the Exclusion of Asma Farooqui. A Case Management visit was conducted on May 26,2022, to confirm receipt of the Decision and Order.

(Cont. 9099-C)

Substantiated

Estimated Days of Completion: 0

SUPERVISOR'S NAME: Gilbert Sena	TELEPHONE: (951) 782-4800
LICENSING EVALUATOR NAME: Claudia Caywood	TELEPHONE: 951-782-4200
LICENSING EVALUATOR SIGNATURE:	DATE: 11/09/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2023

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 3

Control Number 09-CC-20230901095730

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: HAPPY WORLD PRESCHOOL	FACILITY NUMBER: 334846105
	VISIT DATE: 11/09/2023

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Appeal rights issued and discussed with Manzar Farooqui and their signature on this form acknowledges receipt of these rights.

On February 16, 2023, the facility was issued a citation for allowing Ms. Farooqui to be present at the facility during the hours of operation after the effective date of the Decision and Order. During the investigation, LPA conducted interviews with staff and other pertinent individuals. Staff deny having knowledge of any excluded adult at the facility site. Interviews revealed other pertinent individuals had direct contact with Ms. Farooqui during facility hours. Several pertinent individuals stated they had seen or talked to Ms. Farooqui recently within a few days prior to the open investigation phase. Pertinent individuals whose stories corroborated concluded that Ms. Farooqui had in fact been present at the facility well after the May 26, 2022, and February 16, 2023. Based on the interviews, the facility staff did not comply with the Title 22 regulation, 101208 (g) exclusions.

During file reviews, it was discovered that 3 out of the 8 files did not have the required amount of LIC 9224’s present. It is the department’s requirement that when a facility receives Type A violation parents are to be notified of the Type A violation. The LIC 9224 must be signed by the authorized parent and placed inside the child’s file for the remainder of the twelve months from the date it was signed. These findings demonstrate that the facility staff failed to meet the department’s requirements.

Based on LPAs interviews and records review, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations (Title 22, Division 12) are cited on the attached LIC9099-D.

An exit interview was conducted. A copy of this report, appeal rights, acknowledgment of receipt, LIC 811 confidential names list, and Notice of Site Visit was provided to the Licensee, Manzar Farooqui. THIS REPORT MUST BE AVAILABLE TO THE PUBLIC FOR THREE YEARS.

Civil Penalty LIC421IM for $1000.00 was assessed today for a repeat violation.

SUPERVISOR'S NAME: Gilbert Sena	TELEPHONE: (951) 782-4800
LICENSING EVALUATOR NAME: Claudia Caywood	TELEPHONE: 951-782-4200
LICENSING EVALUATOR SIGNATURE:	DATE: 11/09/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 09-CC-20230901095730

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: HAPPY WORLD PRESCHOOL	FACILITY NUMBER: 334846105
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 11/09/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 11/10/2023 Section Cited CCR 101208(g)	1 2 3 4 5 6 7	101208 Exclusions: (g) A licensee's failure to comply with the department's exclusion order after being notified... shall be grounds for disciplining the licensee... to Section 1596.885 or 1596.886. This requirement was not met as evidenced by:	1 2 3 4 5 6 7	Licensee agreed to immediatly remove the exlcuded individual. Licensee agreed to send a written statement of acknowledgement, understanding and compliance to regulation 101208 (g) and send the written statement to the department by 11/10/23.
	8 9 10 11 12 13 14	Based on the interviews, Ms. Farooqui had in fact been present at the facility well after the exclusion dates.The facility staff did not comply with the Title 22 regulation. This is an immediate risk to the health and safety and personal rights of children in care.	8 9 10 11 12 13 14
Type A 11/10/2023 Section Cited HSC 1596.8595(c)	1 2 3 4 5 6 7	A licensed child care facility ...provide to the parents of each child... in the facility copies of any licensing report... any Type A citation... immediate risk to the health, safety, or personal rights of children in care This requirement was not met as evidenced by:	1 2 3 4 5 6 7	Licensee agreed to provide copies of the LIC 9224's to all parents missing the LIC 9224's. Licensee agreed to provide a plan on how the Health and Safety Code 1596/8595 (c) will be met in the furture.
	8 9 10 11 12 13 14	Based on file review it was discovered that 3 out of the 8 files did not have the required amount of LIC 9224’s present. This is an immediate risk to the health and safety and personal rights of children in care.	8 9 10 11 12 13 14

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: Gilbert Sena	TELEPHONE: (951) 782-4800
LICENSING EVALUATOR NAME: Claudia Caywood	TELEPHONE: 951-782-4200
LICENSING EVALUATOR SIGNATURE:	DATE: 11/09/2023

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2023

LIC9099 (FAS) - (06/04)

Page: 3 of 3