364815848-10-13-2023-09-CC-JGIE-CWKPD6-20231013111301

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 364815848
Report Date: 10/13/2023
Date Signed: 10/13/2023 11:13:03 AM

Document Has Been Signed on 10/13/2023 11:13 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME:	KIDZ ROCK CHILDREN'S LEARNING CENTER		FACILITY NUMBER:	364815848
ADMINISTRATOR:	CASTRO, STEPHANIE		FACILITY TYPE:	850
ADDRESS:	2345 S. WATERMAN AVENUE		TELEPHONE:	(909) 264-2000
CITY:	SAN BERNARDINO	STATE: CA	ZIP CODE:	92408
CAPACITY: 99	TOTAL ENROLLED CHILDREN: 99	CENSUS: 18	DATE:	10/13/2023
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME BEGAN:	08:36 AM
MET WITH:	Stephanie Castro		TIME COMPLETED:	11:09 PM

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On 10/13/2023 Licensing Program Analyst (LPA) Justin Giese made an unannounced visit to the facility for the purpose of following-up on the submission of an Unusual Incident Report (UIR) which was submitted by the facility to the Riverside Regional Office on 09/27/2023. LPA met with Facility Director, Stephanie Castro and recorded the following information.

UIR submitted on 09/27/2023 outlined in detail a child incident/accident/injury that occurred on 09/22/2023 around 11:45am. According to UIR facility staff comforted child after incident occurred, documenting events on internal documents and reporting incident to child’s Authorized Representative. It was reported the Child’s Representative spoke to facility staff and had further concerns regarding the incident and wanted to address a potential personal rights violation of the child. The Facility conducted an internal investigation into this matter and collected written statements from staff members involved, including these documents with the submission of the UIR.

On 10/13/2023 LPA conducted a site visit and toured the classroom where the incident occurred. LPA conducted interviews with Facility Director and pertinent individuals involved. LPA recorded corroborating statements from individuals that support the series of events and statements provided with the UIR.

There appear to be NO violations of Title 22 observed at this time. The facility took the appropriate steps to record this incident via UIR and document statements and events from its own internal investigation.

An exit interview was conducted, and report reviewed with Facility Director, Stephanie Castro.

A notice of Site Visit was issued, Facility Director was instructed to display it in a prominent location of the facility for 30 days.

SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Justin Giese
LICENSING EVALUATOR SIGNATURE:	DATE: 10/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/13/2023

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

LIC809 (FAS) - (06/04)

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