336300752-6-14-2023-10-CC-DMUN-CT9UJH-20230629153731

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 336300752
Report Date: 06/14/2023
Date Signed: 06/14/2023 09:34:56 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SOUTH EAST, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/06/2023 and conducted by Evaluator Alaina Wilburn

PUBLIC

COMPLAINT CONTROL NUMBER: 10-CC-20230606151450

FACILITY NAME:	TILLETT FAMILY CHILD CARE		FACILITY NUMBER:	336300752
ADMINISTRATOR:	TILLETT, ANIESHA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(619) 882-1841
CITY:	HEMET	STATE: CA	ZIP CODE:	92545
CAPACITY:	14	CENSUS: 2	DATE:	06/14/2023
		UNANNOUNCED	TIME BEGAN:	08:15 AM
MET WITH:	Aniesha Tillett		TIME COMPLETED:	09:45 AM

ALLEGATION(S):

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Day care child received unexplained injury while in care.

INVESTIGATION FINDINGS:

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At 8:15AM on June 14, 2023, Licensing Program Analyst (LPA) Alaina Wilburn conducted an unannounced 10 day complaint visit. LPA met with Licensee Aniesha Tillett, to discuss the above mentioned allegation.

Investigation consisted of: interview with Licensee, Assistant and other pertinent parties.

Investigation revealed the following; On 06/06/2023, a complaint allegation was received by the Community Care Licensing (CCL) office that day care child received unexplained injury while in care. On 06/01/23, Licensee was watching over 2 day care children. They were playing with one another and running around. Child #1 (C1) fell, which subsequently caused Child #2 (C2) to fall on top of C1's back. According to Licensee, immediately C1 yelled that C2 bit them. Licensee instructed both children to get up, and she checked C1's back. Licensee stated she observed small teeth marks, but there was no broken skin, redness or swelling. Licensee stated the kids continued to play, and she checked C1's back throughout the day and the condition did not change. While there was an incident, it was not due to a lack of supervision, as Licensee

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Deborah Mullen
LICENSING EVALUATOR NAME: Alaina Wilburn
LICENSING EVALUATOR SIGNATURE:	DATE: 06/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 10-CC-20230606151450

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SOUTH EAST, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: TILLETT FAMILY CHILD CARE	FACILITY NUMBER: 336300752
	VISIT DATE: 06/14/2023

NARRATIVE

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was present. Assistant advised she was not present during the incident, but did arrive later in the day for work.

Based on interviews conducted, the allegation that day care child received unexplained injury while in care, may have happened or is valid, but there is not a preponderance of evidence to prove the alleged violation did or did not occur. Therefore, the allegation is UNSUBSTANTIATED at this time.

Exit interview conducted. A copy of this report and appeal rights were discussed and provided to the Licensee Aniesha Tillett on this date.

A NOTICE OF SITE VISIT WAS ISSUED AND LPA VERIFIED THAT IT WAS POSTED IN A PROMINENT LOCATION AT THE FACILITY BEFORE LEAVING. THE LICENSEE UNDERSTANDS THAT IT MUST REMAIN POSTED FOR THE NEXT 30 DAYS.

SUPERVISORS NAME: Deborah Mullen
LICENSING EVALUATOR NAME: Alaina Wilburn
LICENSING EVALUATOR SIGNATURE:	DATE: 06/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2023

LIC9099 (FAS) - (06/04)

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