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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 366426118
Report Date: 03/22/2023
Date Signed: 03/22/2023 12:16:01 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/16/2023 and conducted by Evaluator Paola Guerrero
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20230316145903
FACILITY NAME:FIRST STEP FONTANAFACILITY NUMBER:
366426118
ADMINISTRATOR:VISOR, MARYFACILITY TYPE:
775
ADDRESS:8621 JUNIPER AVE STE 101TELEPHONE:
(909) 428-6201
CITY:FONTANASTATE: CAZIP CODE:
92335
CAPACITY:60CENSUS: 56DATE:
03/22/2023
UNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Chantal SmithTIME COMPLETED:
12:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff hit resident
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Paola Guerrero conducted an unannounced visit to initiate and deliver the findings for the above complaint allegation. LPA met with Facility Administrator Chantal Smith who was informed of the purpose of the visit and the allegation listed above. The investigation consists of direct observations, records review, and interviews with staff and clients regarding the allegation.

The first allegation, Staff hit client. Staff 3- Staff 6 (S3-S6) deny ever hitting any client or witnessing any other staff hitting any client in care. Client 1 - Client 3 (C1-C3) stated they have never been hit by any staff nor have they ever seen staff hit any client in care. Client 4 (C4) stated was present when incident occurred and stated that Staff 1 (S1) never hit client 5 (C5). Client 5 (C5) was unable to corroborate or refute the allegation.

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Paola Guerrero
LICENSING EVALUATOR SIGNATURE:

DATE: 03/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2023
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 2
Control Number 56-AS-20230316145903
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: FIRST STEP FONTANA
FACILITY NUMBER: 366426118
VISIT DATE: 03/22/2023
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
26
27
28
29
30
31
32
Based upon interviews and information gathered, and although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is UNSUBSTANTIATED at this time.

An exit interview was conducted where this report was discussed and provided to Facility Administrator Chantal Smith.
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Paola Guerrero
LICENSING EVALUATOR SIGNATURE:

DATE: 03/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2