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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364845370
Report Date: 02/07/2023
Date Signed: 02/08/2023 11:59:11 AM


Document Has Been Signed on 02/08/2023 11:59 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
INLAND EMPIRE CHILD, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501



FACILITY NAME:KIDDIE ACADEMYFACILITY NUMBER:
364845370
ADMINISTRATOR:PAMELA FOXFACILITY TYPE:
850
ADDRESS:15861 POMONA RINCON RDTELEPHONE:
(909) 529-6661
CITY:CHINO HILLSSTATE: CAZIP CODE:
91709
CAPACITY:144CENSUS: 92DATE:
02/07/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Pamela FoxTIME COMPLETED:
12:45 PM
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Licensing Program Analyst (LPA) Rachel Zeron conducted a case management inspection with Director, Pamela Fox. A case management inspection is being conducted in response to the receipt of an unusual incident report (UIR) from the facility. The UIR was received by the licensing agency on 01/30/2023.

The incident occurred on 01/24/2023, the UIR documented an incident where a staff member was accused of violating a child's personal rights. The incident was self reported and the facility conducted an internal investigation into the matter.

During todays visit, the two staff members that witnessed the incident and the two children that were involved were interviewed. Staff indicated that they witnessed staff 1 (S1) violated both child 1 (C1) and Child 2 (C2) personal rights. According to interviews, S1 was observed restraining a child on S1's lap and at the same time pulling another child's leg approximately one foot back to where S1 was sitting. S1 was attempting to read C1 and C2 a book and appeared to become frustrated when the children did not want sit down. Staff 2 (S2) reported the incident immediately to the director, the video footage of the incident was reviewed. Director was not able to address the incident immediately, S1 had left for the day. A full body check was conducted on both C1 and C2, no injuries were observed. Parents of C1 and C2 were notified. The following day, the incident was addressed with S1 and S1 was terminated for violating C1 and C2's personal rights. Staff received a refresher training on personal rights, as well as reporting requirements.

Based on the information obtained, as well as observation of the video, there appeared to be no violations of Title 22 Regulations pertaining to the reported incident. The facility took immediate action to protect the children's safety and personal rights.

LPA conducted an exit interview with Director, Pamela Fox and provided a copy of this report. A Notice of Site Visit was issued and must remain posted for the next 30 days.
SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951)320-2023
LICENSING EVALUATOR NAME: Rachel ZeronTELEPHONE: (951) 782-4200
LICENSING EVALUATOR SIGNATURE:
DATE: 02/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/07/2023
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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