<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 376300358
Report Date: 06/26/2024
Date Signed: 06/26/2024 04:30:14 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/17/2024 and conducted by Evaluator Gabriela Hernandez
PUBLIC
COMPLAINT CONTROL NUMBER: 10-CC-20240517100704
FACILITY NAME:COLES COTTAGE ACADEMYFACILITY NUMBER:
376300358
ADMINISTRATOR:COSTA,WEERATUNGAFACILITY TYPE:
850
ADDRESS:505 CIVIC CENTER DRTELEPHONE:
(949) 836-4465
CITY:VISTASTATE: CAZIP CODE:
92084
CAPACITY:35CENSUS: 28DATE:
06/26/2024
UNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Weeratung CostaTIME COMPLETED:
03:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility is operating out of ratio
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On June 26, 2024 at 2:30 PM, Licensing Program Analyst (LPA) Gabriela Hernandez arrived unannounced at CCC and met with Director Weeratung Costa to deliver the investigative findings regarding the allegation listed above.

On May 22, 2024 at 8:30 am, LPA Gabriela Hernandez opened the investigation at the CCC and conducted a census. During the investigation, LPA conducted confidential interviews with 7 staff members (D1,S1,S2,S3,S4,S5,S6). LPA also obtained copies of parent/children sign in sheet and employee timecards. LPA reviewed parent/children sign in sheets and the time cards for employees on 5 random dates from May 2, 2024 thru May 16, 2024 and it did not show the facility was operating out of ratio. It is important to note that some parents do forget to sign in and some writing is ineligible on the sign in sheet.

Continued on 9099C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: Gabriela Hernandez
LICENSING EVALUATOR SIGNATURE:

DATE: 06/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2024
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 10-CC-20240517100704
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: COLES COTTAGE ACADEMY
FACILITY NUMBER: 376300358
VISIT DATE: 06/26/2024
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
On May 17, 2024, a complaint was received alleging the facility is operating out of ratio. Regarding the allegation that facility is operating out of ratio, confidential interviews revealed that classrooms remain in ratio and will call front desk or cook who also assists as aide if any help is needed. Additionally, LPA conducted visits on 2 separate occasions (05/22/24 and 06/26/24)and LPA did not observe the facility operating out of ratio.

Based on the information obtained during this investigation, it has been determined that although the allegations may have happened or are valid, there is not a preponderance of evidence to prove that the alleged violations did or did not occur. Therefore, the allegations are UNSUBSTANTIATED.

A notice of site visit was provided and must remain posted for 30 days. A copy of this report and appeal rights were given and explained to Director Weeratung Costa.
SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: Gabriela Hernandez
LICENSING EVALUATOR SIGNATURE:

DATE: 06/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2