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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701357
Report Date: 11/30/2023
Date Signed: 11/30/2023 02:57:09 PM

Document Has Been Signed on 11/30/2023 02:57 PM - 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 SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:QCS CHILDRENS COVE CHILD DEVELOPMENT CENTERFACILITY NUMBER:
376701357
ADMINISTRATOR:ALIYA KHANFACILITY TYPE:
850
ADDRESS:3239 CONCH WAYTELEPHONE:
(760) 435-2006
CITY:OCEANSIDESTATE: CAZIP CODE:
92058
CAPACITY: 52TOTAL ENROLLED CHILDREN: 33CENSUS: 16DATE:
11/30/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:05 PM
MET WITH:Aliya KhanTIME COMPLETED:
03:05 PM
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Licensing Program Analyst (LPA) Keely Messerschmidt arrived at the facility on a case management inspection to follow-up on an Unusual Incident Report (UIR) which occurred on October 23rd, 2023 per Director. LPA met with Director Aliya Khan, and provided purpose of inspection. At the time of inspection, LPA toured the facility, took census, interviewed and reviewed documents previously submitted to the department with Director.

The reported incident took place on October 23rd, 2023, regarding a child that had choked on a hair clip.

LPA interviewed Director and confirmed that Child #1 (C1), had swallowed her hair clip during nap time and began choking. Director stated that S1 went to child having her stand up and once S1 noticed C1 was choking she began the heimlich maneuver on C1. Director told S2 to contact 911 and child's parents. The Director and S1 took turns administering the heimlich maneuver until C1 spit the hair clip out. When the paramedics arrived they checked C1's vitals and cleared her to stay at the facility. Less than an hour after the incident took place, child was picked up from the facility and returned the next day.

An exit interview was conducted with Director Aliya Khan and a copy of this report was provided along with the Notice of Site visit.

Notice of site visit must remain posted for 30 days.
SUPERVISORS NAME: Deborah Mullen
LICENSING EVALUATOR NAME: Keely Messerschmidt
LICENSING EVALUATOR SIGNATURE: DATE: 11/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/30/2023
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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