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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 364817412
Report Date: 12/09/2021
Date Signed: 12/09/2021 02:07:08 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
09/29/2021 and conducted by Evaluator Donna Maddox
PUBLIC
COMPLAINT CONTROL NUMBER: 12-CC-20210929085419
FACILITY NAME:FUNDAMENTALS PRESCHOOL ACADEMY, THEFACILITY NUMBER:
364817412
ADMINISTRATOR:EVELYN CHINCHILLAFACILITY TYPE:
850
ADDRESS:2424 KENDALL DRIVETELEPHONE:
(909) 887-1150
CITY:SAN BERNARDINOSTATE: CAZIP CODE:
92407
CAPACITY:45CENSUS: 0DATE:
12/09/2021
UNANNOUNCEDTIME BEGAN:
01:20 PM
MET WITH:Evelyn CHINCHILLATIME COMPLETED:
02:20 PM
ALLEGATION(S):
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Transportation: Staff do not transport daycare children in a safe manner.
Reporting Requirments: Staff did not report incident to daycare child's responsible party
INVESTIGATION FINDINGS:
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Licensing Program Analyst(s) Maddox and Ibitoye met with Director, Evelyn Chinchilla for the purpose of concluding the above complaint allegations. During this investigation, there were 0 School age children present.
As part of this complaint investigation, LPA interviewed staff, parent, children, and pictures were taken of the transportation vehicles. Transportation vehicle #1 is equipped to transport 7 children, Transportation vehicle #2 is equipped to transport 8 children, booster seats are also available. Children interviewed stated they all had seatbelts on while being transported to school. Staff interviewed admit 2 children got into a physical altercation while he was driving the children to school, staff stated when he arrived at the school, he checked both children to see if he noticed any visible injuries, staff stated he didn't notice any injuries on either child. Parent of child #1 was contacted by staff from child's elementary school to inform her child #1 arrived at school with an injury.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE:

DATE: 12/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2021
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 5
Control Number 12-CC-20210929085419
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: FUNDAMENTALS PRESCHOOL ACADEMY, THE
FACILITY NUMBER: 364817412
VISIT DATE: 12/09/2021
NARRATIVE
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Staff stated he planned on contacting both parents (of children involved in the physical altercation) once they returned to the center, but in the interim, parent contacted them.
Based on interviews and evidence presented, this complaint is rendered Unsubstantiated. A conclusion of Unsubstantiated means, although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.
Exit interview conducted, copy of report left with Director, Evelyn Chinchilla.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE:

DATE: 12/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2021
LIC9099 (FAS) - (06/04)
Page: 5 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
09/29/2021 and conducted by Evaluator Donna Maddox
COMPLAINT CONTROL NUMBER: 12-CC-20210929085419

FACILITY NAME:FUNDAMENTALS PRESCHOOL ACADEMY, THEFACILITY NUMBER:
364817412
ADMINISTRATOR:EVELYN CHINCHILLAFACILITY TYPE:
850
ADDRESS:2424 KENDALL DRIVETELEPHONE:
(909) 887-1150
CITY:SAN BERNARDINOSTATE: CAZIP CODE:
92407
CAPACITY:45CENSUS: 0DATE:
12/09/2021
UNANNOUNCEDTIME BEGAN:
01:20 PM
MET WITH:Evelyn CHINCHILLATIME COMPLETED:
02:20 PM
ALLEGATION(S):
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Staff do not provide adequate supervision.
INVESTIGATION FINDINGS:
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Licensing Program Analyst(s) Maddox and Ibitoye met with Director, Ms Evelyn today for the purpose of concluding the above complaint allegation. During this investigation, there were no School age children present.

Before concluding this complaint investigation, LPA interviewed parent, staff, and children involved. Based on interviews, Child #1 and Child #2 had a physical altercation the previous day and expressed they did not want to sit together the following day. Staff ignored their request and had the 2 children sit together again and due to the ill feelings of the previous day, the 2 children got into a second altercation while being transported to school.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE:

DATE: 12/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 12-CC-20210929085419
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: FUNDAMENTALS PRESCHOOL ACADEMY, THE
FACILITY NUMBER: 364817412
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/09/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/16/2021
Section Cited
CCR
101229
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Responsibility for Providing Care and Supervision.(a) The licensee shall provide care and supervision as necessary to meet the children's needs. This requirement was not met as evidenced by: Staff allowed the
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Staff met and decided they would update their admission agreement to include the 2 week trial period upon enrollment and add a sentence that states if the behavior threatens the health and safety of staff and/or
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2 children to sit together again the day after they had a physical altercation the prior day which led to a second altercation which led to child #1 sustaining an injury.
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other children services will be terminated.
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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: Mariela Ramon
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE:

DATE: 12/09/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2021
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 12-CC-20210929085419
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: FUNDAMENTALS PRESCHOOL ACADEMY, THE
FACILITY NUMBER: 364817412
VISIT DATE: 12/09/2021
NARRATIVE
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 This second altercation may have been avoided if two things could have transpired, #1 - Staff could have swapped seats for the two children due to the previous altercation, or #2 - A second staff person could have sat in the back with the children to provide adequate supervision while the other staff person was driving. With this information, the “preponderance of the evidence” standard has been met and the above allegation is Substantiated.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE:

DATE: 12/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2021
LIC9099 (FAS) - (06/04)
Page: 4 of 5