364846600-5-7-2026-09-CC-RMOD-DTUMAL-20260507092632

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 364846600
Report Date: 05/07/2026
Date Signed: 05/07/2026 09:26:43 AM

Document Has Been Signed on 05/07/2026 09:26 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
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME:	SBCSS LUGONIA STATE PRESCHOOL		FACILITY NUMBER:	364846600
ADMINISTRATOR/ DIRECTOR:	MARITZA MEDINA		FACILITY TYPE:	860
ADDRESS:	202 E. PENNSYLVANIA AVENUE		TELEPHONE:	(909) 387-8517
CITY:	REDLANDS	STATE: CA	ZIP CODE:	92374
CAPACITY: 24	TOTAL ENROLLED CHILDREN: 28	CENSUS: 9	DATE:	05/07/2026
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	08:25 AM
MET WITH:	Lead Teacher Maritza Medina		TIME VISIT/ INSPECTION COMPLETED:	09:35 AM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On date and time listed above, Licensing Program Analyst (LPA) Raymond Moorehead arrived at the facility to conclude an Unusual Incident Report (UIR) case management visit. This report was received by the Department as a self-reported incident from the facility. The incident reported an allegation that a child attempted to touch another child inappropriately an inappropriate manner. During today’s visit, LPA met with Lead Teacher Maritza Medina, and conducted a tour/census. Throughout the course of the investigation, LPA conducted interviews with pertinent individuals, made observations, and collected documentation. The following was mentioned and/or discussed. It was initially reported by the facility that a child disclosed to their authorized representative that another child had attempted to touch them in an inappropriate manner. Throughout the course of the investigation, staff interviews indicated that supervising staff members did not directly witness the alleged conduct. Staff reported that no direct observations were made confirming the alleged inappropriate contact, and no corroborating staff evidence was obtained to substantiate the exact nature of the reported behavior. Continued on LIC 809-C.

NAME OF LICENSING PROGRAM MANAGER: Aaron Ross
NAME OF LICENSING PROGRAM ANALYST: Raymond Moorehead
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/07/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2026

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: SBCSS LUGONIA STATE PRESCHOOL	FACILITY NUMBER: 364846600
	VISIT DATE: 05/07/2026

NARRATIVE

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Child interviews provided conflicting disclosures. One child disclosed that the other child had attempted inappropriate touching involving the chest area and attempted to view undergarments, while the other child denied the allegation. Although concerns regarding peer interactions were present, conflicting statements and the absence of direct witness corroboration limited the Department’s ability to conclusively determine whether the reported conduct occurred as described.

Based on observations, documentation, and interviews conducted throughout the investigation, there was insufficient evidence to determine that a violation of Title 22 regulations occurred, specifically pertaining to supervision requirements. Although the reported incident was taken seriously and appropriately self-reported by the facility, the preponderance of evidence did not support a definitive finding of regulatory noncompliance.

The investigation was concluded, and at this time, no Title 22 violations were identified based on the information obtained.

NAME OF LICENSING PROGRAM MANAGER: Aaron Ross
NAME OF LICENSING PROGRAM ANALYST: Raymond Moorehead
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/07/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2026

LIC809 (FAS) - (06/04)

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