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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 364808413
Report Date: 01/10/2024
Date Signed: 01/10/2024 03:09:59 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/20/2023 and conducted by Evaluator Kendal Zirbes
PUBLIC
COMPLAINT CONTROL NUMBER: 12-CC-20231020162933
FACILITY NAME:SAN BERNARDINO CHILD DEVELOPMENT CENTERFACILITY NUMBER:
364808413
ADMINISTRATOR:LATASHIA KELLYFACILITY TYPE:
830
ADDRESS:2350 N. E STREETTELEPHONE:
(909) 388-6307
CITY:SAN BERNARDINOSTATE: CAZIP CODE:
92405
CAPACITY:34CENSUS: 9DATE:
01/10/2024
UNANNOUNCEDTIME BEGAN:
01:50 PM
MET WITH:Facility Representative Annabell Magana
TIME COMPLETED:
03:20 PM
ALLEGATION(S):
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Staff did not prevent day care child from biting another child in care
INVESTIGATION FINDINGS:
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On January 10, 2024, Licensing Program Analyst (LPA) Zirbes conducted a follow-up complaint inspection to San Bernardino Child Development Center. LPA met with facility representative Annabell Magana. The purpose of the inspection was to deliver the findings regarding the above complaint allegation. The investigation included an inspection of the facility, a review of facility records, and confidential interviews with staff and parents.
On October 20, 2023, the Department received an allegation alleging child 1 (C1) was bitten by an unknown child more than five times in recent months. Staff interviews confirmed C1 was bitten by child 2 (C2) on multiple occasions after transitioning to the toddler classroom. Staff interviews reported the authorized representatives were notified and provided with written and/or verbal notifications. Furthermore, a plan was implemented for the staff to stay close to C2, complete observations and provide positive feedback for positive behavior. Staff interviews confirmed after a plan was put into place, biting incidents continued because the biting behavior occurred suddenly. Parent interviews reported the Center provides verbal and written reports regarding their child’s day. Report continued on page two
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:

DATE: 01/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2024
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 3
Control Number 12-CC-20231020162933
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: SAN BERNARDINO CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 364808413
VISIT DATE: 01/10/2024
NARRATIVE
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Report continued from page one

Parent interviews confirmed knowledge of the biting behavior and reported C2 is paired with a teacher. Additional parent interviews confirmed their child was involved in biting incidents while enrolled at the Center. Per LPA’s record review, C1 was bitten four times by another child on 8.21.23, 8.24.23, 10.11.23, 10.17.23. The Center had a joint meeting with the family to discuss the behavior on October 23, 2023. The biting behavior was not documented on the Needs and Service plan.

Based on the interviews conducted and a review of the records, the preponderance of evidence standard has been met. Therefore, the above allegation is found to be SUBSTANTIATED. A citation was issued on the LIC 9099D for California Code of Regulations, Title 22, Division 12, Chapter 1, regulation 101223 (a) (2).

A Notice of Site Visit was given and must remain posted for 30 days. An exit interview was conducted, and the report was reviewed with facility representative Annabell Magana.
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:

DATE: 01/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 12-CC-20231020162933
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: SAN BERNARDINO CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 364808413
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/10/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type B
01/24/2024
Section Cited
CCR
101223(a)(2)
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Personal Rights - (a) The licensee shall ensure that each child is accorded the following personal rights: (2) To be accorded safe, healthful and ...to meet his/her needs. This requirement was not met as evidenced by:
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Per facility representative, a staff training regarding personal rights and supervision will take place. A copy of the training and sign in sheet will be provided to the Department.
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Based on interviews and record review, the Licensee did not ensure C1 was provided a safe environment when C1 was bitten four times by C2 between August 2023 and October 2023.
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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: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:

DATE: 01/10/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3