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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426207338
Report Date: 10/05/2022
Date Signed: 12/22/2023 10:47:34 AM

Document Has Been Signed on 12/22/2023 10:47 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
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:STORYTELLER CHILDREN'S CENTERFACILITY NUMBER:
426207338
ADMINISTRATOR:JAQUELINE MCDONOUGHFACILITY TYPE:
850
ADDRESS:2115 STATE ST.TELEPHONE:
(805) 682-9585
CITY:SANTA BARBARASTATE: CAZIP CODE:
93105
CAPACITY: 42TOTAL ENROLLED CHILDREN: 42CENSUS: 17DATE:
10/05/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
04:10 PM
MET WITH:Jaqueline McDonoughTIME COMPLETED:
05:30 PM
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The purpose of this amendment is to update the administrator's name.

On 10/5/2022, at 4:17pm, Licensing Program Analyst (LPA) Rosie made an unannounced visit for the purpose of conducting a Case Management - Incident inspection. LPA met with facility director, Jacqueline McDonough and discussed the purpose of the visit. LPA and licensee conducted a tour of the facility inside and out and there were 17 children and 5 staff at the time of the inspection.

On 9/30/2022, director Jacqueline McDonough contacted Community Care Licensing (CCL) to self-report an incident that occurred on 9/30/2022 of teacher Fernando Moran grabbing a child in the PK room by the arm, shaking child and forcing child to sit.

Director states: on 9/30/2022 (Friday) I was going downstairs (PK) at noon, to relieve teacher for his lunch break. No other teachers present, and teacher had roughly a group of 8 children. Another teacher (site supervisor Myra Lopez) was around the corner taking children to restroom.

I immediately saw C1 standing with teacher and teacher was using his right arm and grabbing C1 right arm in between elbow and shoulder. He started shaking C1 and forcing to sit in a chair. He jolted C1 down and was telling C1 “you listen to me!” and I was surprised. Child looked so scared, C1 facial expression was scared and staring at him. All children in the room were staring at him and watched this happen. I call this his “breaking point.” Immediately when C1 sat in chair, he looked at me because I think he heard door open, and I said, “you know you should not handle children like that, you are to go to lunch, clock out and do not return to this center for the rest of the day.” He replied “OK” and gathered his things and left. In that time frame, C1 ran out of the room and hid under the play structure.

CONTINUED ON LIC809C

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Susana Martinez
LICENSING EVALUATOR SIGNATURE: DATE: 10/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/05/2022
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: STORYTELLER CHILDREN'S CENTER
FACILITY NUMBER: 426207338
VISIT DATE: 10/05/2022
NARRATIVE
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Myra and I switched for ratio purposes and I went to C1. C1 was crying and saying, “I’ll listen” and then holding arm, crying saying was scared. I did not see any redness or marks, I looked at arm (short sleeve shirt). Later in the day, I asked if C1 if ok and C1 said good then was playing as normal. Prior to nap, C1 seemed anxious and clung to me the entire time prior to nap. After nap, returned to normal play.

I couldn’t contact parents right away because short staffed so spoke with them at pick up, C1 mother picked up. I told mother what was witnessed, the whole story. I told her this has taken away the child’s personal rights, the teacher has been removed from campus. I told her she had the right to call licensing and encouraged her to do so because it is her right to protect the rights of her child. And I told her what action we (facility) took. Mom started crying and told me there was a DV trauma that C1 witnessed when younger and doesn’t want to have happen and she brought C1 here to be safe. I advised mom we were terminating employee –I was very open with her.

After teacher was removed that day, I contact HQ via walkie talkie and spoke with HR (Adriana Serdio) and Executive Directior Gabriela Garcia and briefed them on incident. All were in agreement of exiting teacher. Incident happened on a Friday, I contacted him that afternoon and told him to return his laptop and iPad because he is not to work offsite, and he did not respond. He did not respond to HR calls either. Then I locked him out of email and all electronic access to children’s information. At some point on Friday he returned iPad and computer to front desk, after children had left, but did not return keys. Sunday night I sent him a text and that needed to meet at 8 am on Monday at executive director’s office. Our recourse was to terminate him. He did not pick up or return text.

CONTINUED ON LIC809C

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Maryrose Breault
LICENSING EVALUATOR SIGNATURE:

DATE: 10/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2022
LIC809 (FAS) - (06/04)
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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
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: STORYTELLER CHILDREN'S CENTER
FACILITY NUMBER: 426207338
VISIT DATE: 10/05/2022
NARRATIVE
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Teacher sent a text on Monday morning around 6AM stating he was not coming and not feeling well. Monday morning, we sent him an email with a letter noting he was dismissed and then made a phone call. Letter was also sent to 1st class mail. He texted HR that he received letter – confirmed it.

C1 returned next day after incident on Friday, and mom stated she appreciated I told her of the incident rather than the child. Mom did not indicate that she sought medical treatment for C1. Mom didn’t ask any other questions or give any further info. C1 was good throughout the day, had a good day and didn’t ask about Teacher

To date, facility has terminated employee, talked to all staff that employee was let go. Admin has an all staff in-service meeting on the 10/10/2022. Adriana sent teacher an envelope to return keys. If not retrieved, will change locks.

Based on above information, child’s rights were violated under Title 22 Division 12 101221 (a) (3). A TYPE A deficiency has been cited on attached LIC809D and LIC9224 provided to director.

Notice of Site Visit has been provided and to remain posted for 30 days.

Appeal rights provided.

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Maryrose Breault
LICENSING EVALUATOR SIGNATURE:

DATE: 10/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2022
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 10/05/2022 05:24 PM - It Cannot Be Edited


Created By: Maryrose Breault On 10/05/2022 at 05:11 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: STORYTELLER CHILDREN'S CENTER
FACILITY NUMBER: 426207338

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/05/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/17/2022
Section Cited
CCR
101221(a)(3)

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The licensee shall ensure that each child is accorded the following personal rights:To be free from corporal or unusual punishment, infliction of pain....
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Director to meet at CCLD Regional Office in Goleta with Licensing Program Manager and Licensing Program Analyst.
All staff to take Mandatory Reporter Training and provide certificates to LPA
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This is evidenced by: self reported incident witnessed by director that child's personal rights were violated.
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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.
SUPERVISOR'S NAME:Ana Tolentino
LICENSING EVALUATOR NAME:Maryrose Breault
LICENSING EVALUATOR SIGNATURE:
DATE: 10/05/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/05/2022


LIC809 (FAS) - (06/04)
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