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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 334846109
Report Date: 02/07/2025
Date Signed: 02/07/2025 09:32:27 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE CC RO, 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
01/13/2025 and conducted by Evaluator Giselle Carbullido
PUBLIC
COMPLAINT CONTROL NUMBER: 09-CC-20250113091231
FACILITY NAME:TRF ALL SAINTSFACILITY NUMBER:
334846109
ADMINISTRATOR:MEJICO, DANETTEFACILITY TYPE:
830
ADDRESS:3847 TERRACINA DRIVETELEPHONE:
(310) 420-1025
CITY:RIVERSIDESTATE: CAZIP CODE:
92506
CAPACITY:32CENSUS: 12DATE:
02/07/2025
UNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Jacqueline HinojosaTIME COMPLETED:
09:30 AM
ALLEGATION(S):
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Staff does not provide adequate supervision to day care children.
INVESTIGATION FINDINGS:
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On the date and time listed above, Licensing Program Analyst (LPA) Giselle Carbullido conducted a subsequent complaint investigation to deliver final findings. An initial visit was conducted on 01/15/2025 at which time LPA Carbullido conducted interviews and reviewed records. LPA met with facility representative, Jacqueline Hinojosa; toured the facility, and took a census.
During the investigation, LPA interviewed all pertinent parties, including facility staff and reviewed records.
It was alleged staff did not provide adequate supervision to day care children. Pertinent party interviews reported adequate supervision was not provided when a staff was observed with their eyes closed while holding a child, requiring another staff to “wake” the staff. This inadequate supervision resulted in an unsafe and unhealthful environment for the child being held.
Based on interviews conducted and documentation reviewed, the Department has determined the preponderance of evidence standard has been met; therefore, the above allegation is found to be SUBSTANTIATED, per California Code of Regulations, Title 22, Division 12.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Giselle Carbullido
LICENSING EVALUATOR SIGNATURE:

DATE: 02/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2025
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-20250113091231
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: TRF ALL SAINTS
FACILITY NUMBER: 334846109
VISIT DATE: 02/07/2025
NARRATIVE
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See LIC9099D for deficiency cited.
An exit interview was conducted, and appeal rights discussed. LPA provided Facility representative, Jacqueline Hinojosa with a copy of this report, notice of site visit and appeal rights.
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Giselle Carbullido
LICENSING EVALUATOR SIGNATURE:

DATE: 02/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 09-CC-20250113091231
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: TRF ALL SAINTS
FACILITY NUMBER: 334846109
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/07/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/11/2025
Section Cited
CCR
101223(a)(2)
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Personal Rights: 101223(a)(2)-(2)To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs.
This requirement is not met as evdenced by:
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Facility will submit a written plan for monitoring and understanding of personal rights by POC due date 02/11/2025.
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Based on LPA's interviews conducted the Licensee did not comply with the section cited above in that a child was not provided safe, healthful and comfortable accomodatiions. 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: 02/07/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3