364817393-4-19-2022-09-CC-GSEA-CDPKZ4-20220421082004

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 364817393
Report Date: 04/19/2022
Date Signed: 04/19/2022 11:42:22 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
03/18/2022 and conducted by Evaluator Justin Giese

PUBLIC

COMPLAINT CONTROL NUMBER: 09-CC-20220318170012

FACILITY NAME:	EASTER SEALS CHILD DEVELOPMENT CENTER-ONTARIO		FACILITY NUMBER:	364817393
ADMINISTRATOR:	ANNA CRUZ		FACILITY TYPE:	850
ADDRESS:	2999 S. HAVEN AVE		TELEPHONE:	(909) 923-3352
CITY:	ONTARIO	STATE: CA	ZIP CODE:	91761
CAPACITY:	48	CENSUS: 30	DATE:	04/19/2022
		UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Anna Cruz		TIME COMPLETED:	11:40 AM

ALLEGATION(S):

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Staff inappropriately handled child

INVESTIGATION FINDINGS:

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On 04/19/2022 at time listed above Licensing Program Analyst (LPA) Justin Giese made an unannounced visit to the facility for the purpose of concluding a complaint investigation. LPA met with Director, Anna Cruz regarding the above allegation, which were received on March 18th, 2022.

The following was alleged: Staff inappropriately handled child

It was alleged Facility Staff shoved a child by the head and told the child to "get out of the way". On 03/21/2022 Facility Director submitted an Unusual Incident Report (UIR) to licensing. UIR stated that on 03/16/2022 Facility Director was made aware of a possible incident that occurred in the 2’s classroom. UIR detailed information that was provided to the Facility Director, identified individuals involved and the steps taken by Facility Director to investigate and report to Licensing. Information stated in the UIR did not fully corroborate or align with what is alleged in this complaint investigation.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Justin Giese
LICENSING EVALUATOR SIGNATURE:	DATE: 04/19/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2022

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 09-CC-20220318170012

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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

FACILITY NAME: EASTER SEALS CHILD DEVELOPMENT CENTER-ONTARIO	FACILITY NUMBER: 364817393
	VISIT DATE: 04/19/2022

NARRATIVE

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On 03/28/2022, LPA Giese made an unannounced visit to the facility for the purpose of initiating this complaint investigation. LPA referred to the submitted UIR and reviewed records/documents, interviewed staff, and made direct observations where the alleged incident had occurred in the facility. Through observation and interview process, LPA recorded conflicting information from individuals interviewed from what was originally alleged and what was recorded on the UIR. The facility conducted its own investigation into the details of the UIR and supplied LPA with written statements from staff as well as documents outlining the Facility’s process for reporting and recording incidents.

Although the Facility reported an incident and conducted their own investigation, LPA was unable to corroborate what was being alleged based interviews and documents obtained. Therefore, due to conflicting information found throughout this investigation this agency has investigated the complaint alleging Staff inappropriately handled child. Although the allegation may have happened, or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

A NOTICE OF SITE VISIT WAS GIVEN. DIRECTOR WAS INSTRUCTED TO POSTED IT IN A PROMINENT LOCATION AT THE FACILITY. THE DIRECTOR UNDERSTANDS THAT IT MUST REMAIN POSTED FOR THE NEXT 30 DAYS.

An exit interview was conducted, A copy of this report and appeal rights were given to the Director during this inspection on 04/19/2022.

SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Justin Giese
LICENSING EVALUATOR SIGNATURE:	DATE: 04/19/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2022

LIC9099 (FAS) - (06/04)

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