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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 376701245
Report Date: 10/26/2022
Date Signed: 10/26/2022 09:55:00 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
09/22/2022 and conducted by Evaluator Alaina Wilburn
PUBLIC
COMPLAINT CONTROL NUMBER: 10-CC-20220922102448
FACILITY NAME:OCEANSIDE SHINING STARS INFANT CENTERFACILITY NUMBER:
376701245
ADMINISTRATOR:MCKENNA SHIVERFACILITY TYPE:
830
ADDRESS:1122 SOUTH COAST HIGHWAYTELEPHONE:
(760) 435-0713
CITY:OCEANSIDESTATE: CAZIP CODE:
92054
CAPACITY:16CENSUS: 12DATE:
10/26/2022
UNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Shams NassarTIME COMPLETED:
10:05 AM
ALLEGATION(S):
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Licensee did not ensure that staff was fingerprint cleared and associated prior to supervising children
INVESTIGATION FINDINGS:
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At 9:15AM on October 26, 2022, Licensing Program Analyst (LPA) Alaina Wilburn met with Licensee Shams Nassar, to deliver investigative findings on the above stated allegation. Investigation consisted of personnel record reviews and interviews with staff, children and a potential witness.

On 09/22/2022, a complaint allegation was received by the Community Care Licensing (CCL) office that licensee did not ensure that staff was fingerprint cleared and associated prior to supervising children. During the initial complaint inspection on 09/26/22, LPA Wilburn reviewed the Facility Personnel Summary Report and did not observe Staff #1 associated to the facility. Licensee advised on 09/16/22, she called the CCL office and confirmed S1 did have an active clearance, so she emailed an LIC 9182 and copy of S1's ID card to Associations_Disassociations858@dss.ca.gov. S1 started working at the facility on 09/19/22. LPA checked S1 in the Licensing Information System and observed S1 does have a clearance, but S1 has an exemption that had not been approved for a transfer to the facility. After the initial inspection, Licensee emailed LPA that she observed her notes and the CCL representative informed her that S1 had an exemption, so the licensee
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Stephanie Hudak
LICENSING EVALUATOR NAME: Alaina Wilburn
LICENSING EVALUATOR SIGNATURE:

DATE: 10/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2022
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 10-CC-20220922102448
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: OCEANSIDE SHINING STARS INFANT CENTER
FACILITY NUMBER: 376701245
VISIT DATE: 10/26/2022
NARRATIVE
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would have to submit an LIC 9188. Licensee advised she got busy, was overwhelmed and forgot to follow through and submit the required form to associate S1 fingerprint exemption.

Based on record review, interviews conducted and LPAs observation, the preponderance of evidence standard has been met and the allegation that licensee did not ensure that staff was fingerprint cleared and associated prior to supervising children is found to be SUBSTANTIATED. The facility is being cited in accordance with Title 22 Child Care Center Regulations, Division 12, Chapter 1, Section 101170 (e)(3): Criminal Record Clearance. This posed an immediate risk to the health, safety, or personal rights to the children in care. See LIC9099D for cited deficiency.

Exit interview conducted. A copy of this report, Civil Penalty Assessment (LIC 421BG), and appeal rights were discussed and provided to the licensee Shams Nassar on this date.

A NOTICE OF SITE VISIT WAS ISSUED AND LPA VERIFIED THAT IT WAS POSTED IN A PROMINENT LOCATION AT THE FACILITY BEFORE LEAVING. THE LICENSEE UNDERSTANDS THAT IT MUST REMAIN POSTED FOR THE NEXT 30 DAYS ALONG WITH A COPY OF THE TYPE A DEFICIENCY (9099D) CITED DURING THIS INSPECTION. A COPY OF THE TYPE A DEFICIENCY CITED DURING THIS INSPECTION MUST ALSO BE IMMEDIATELY (within 24 hours of the child’s next day in care) GIVEN TO THE PARENTS OF ALL CHILDREN ENROLLED IN THE CHILD CARE FACILITY AND ANY CHILDREN ENROLLED INTO THE CHILD CARE FACILITY OVER THE NEXT 12 MONTHS.
SUPERVISORS NAME: Stephanie Hudak
LICENSING EVALUATOR NAME: Alaina Wilburn
LICENSING EVALUATOR SIGNATURE:

DATE: 10/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 10-CC-20220922102448
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: OCEANSIDE SHINING STARS INFANT CENTER
FACILITY NUMBER: 376701245
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/26/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/27/2022
Section Cited
CCR
101170(e)(3)
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Criminal Record Clearance(e) All individuals subject to a criminal record review pursuant to H&S1596.871 shall prior to working, residing or volunteering in a licensed facility: (3)Request and be approved for a transfer of a criminal record exemption, as specified in Section 101170.1(r), unless, upon request for a transfer, the Department permits the individual to be employed, reside or be present at the facility.
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S1 no longer works for the facility. S1's last day was 09/22. Licensee understands she is to confirm clearance and association prior to an individuals initial presence in the facility. LPA provided Licensee with a copy of Title 22 Regulations, Section 101170 and 101170.1. Civil Penalties Assessed during today's visit.
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The requirement is not met as evidenced by: S1 started working at the facility on 09/19/22, and the Licensee failed to submit an LIC 9188, a clear current copy of an ID card and an LIC 508 to the CCL office, and failed to confirm transfer of association prior to S1's initial presence in the facility, which poses an immediate health, safety or personal rights risk to children in care.
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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: Stephanie Hudak
LICENSING EVALUATOR NAME: Alaina Wilburn
LICENSING EVALUATOR SIGNATURE:

DATE: 10/26/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2022
LIC9099 (FAS) - (06/04)
Page: 5 of 5