Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 330909315
Report Date: 07/19/2016
Date Signed: 07/19/2016 12:11:02 PM


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 ST., SUITE 700
RIVERSIDE, CA 92501
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/31/2016 and conducted by Evaluator Alda Aguirre
PUBLIC
COMPLAINT CONTROL NUMBER: 09-CC-20160531161943
FACILITY NAME:V.I.P. TOTSFACILITY NUMBER:
330909315
ADMINISTRATOR:KAREN CALVILLOFACILITY TYPE:
850
ADDRESS:41861 E. ACACIA AVENUETELEPHONE:
(951) 652-7611
CITY:HEMETSTATE: CAZIP CODE:
92544
CAPACITY:86CENSUS: 0DATE:
07/19/2016
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Karen CalvilloTIME COMPLETED:
12:15 PM
ALLEGATION(S):
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License: Facility is out of ratio and/or in violation of their own Plan of Operation.
Employee Rights: Staff being threatened and/or intimidated after previous complaint.
INVESTIGATION FINDINGS:
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Licensing Program Manager (LPM) Anita Hise and Licensing Program Analysts (LPAs) Sharleen Robinson and Alda Aguirre held an informal meeting at the Community Care Licensing Riverside Regional Office regarding a complaint received concerning the above allegation. Executive Director Karen Calvillo, Marcela Arnold, Debbie Haney, and Marcia Nogrady attended the meeting to discuss the complaint/allegation.

The following was alleged: Facility is out of ratio and/or in violation of their own Plan of Operation.

Licensing Program Analysts (LPAs) Lopez and Aguirre investigated the above allegations and gathered the following information: The facility has continued to operate in compliance with the Title 22 Requirements that apply to the preschool license, however, the facility submitted a Plan of Operation to Community Care Licensing stating that the facility would operate with a ratio of 4 children, to be supervised by 1 teacher for the toddler program and 8-10 children to 1 teacher in the preschool classroom. The facility has not operated within the ratios indicated on their license because the facility has operated a classroom of 17 preschool children, including special needs
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Anita HiseTELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Alda AguirreTELEPHONE: (951) 218-5196
LICENSING EVALUATOR SIGNATURE:

DATE: 07/19/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2016
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 7



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 ST., SUITE 700
RIVERSIDE, CA 92501
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/31/2016 and conducted by Evaluator Alda Aguirre
PUBLIC
COMPLAINT CONTROL NUMBER: 09-CC-20160531161943

FACILITY NAME:V.I.P. TOTSFACILITY NUMBER:
330909315
ADMINISTRATOR:KAREN CALVILLOFACILITY TYPE:
850
ADDRESS:41861 E. ACACIA AVENUETELEPHONE:
(951) 652-7611
CITY:HEMETSTATE: CAZIP CODE:
92544
CAPACITY:86CENSUS: 0DATE:
07/19/2016
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Karen CalvilloTIME COMPLETED:
12:15 PM
ALLEGATION(S):
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Personal Rights: Children not accorded dignity in relationship with staff.
INVESTIGATION FINDINGS:
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Licensing Program Manager (LPM) Anita Hise and Licensing Program Analysts (LPAs) Sharleen Robinson and Alda Aguirre held an informal meeting at the Community Care Licensing Riverside Regional Office regarding a complaint received concerning the above allegation. Executive Director Karen Calvillo, Marcela Arnold, Debbie Haney, and Marcia Nogrady attended the meeting to discuss the complaint/allegation.

The following was alleged: Children not accorded dignity in relationship with staff.

During the investigation it was learned that the allegation was made regarding an incident when a child was talking and was interrupted by a staff member. Interviews were conducted and records were reviewed however there were no witnesses that could corroborate that the incident affected the child and it was unclear what child the incident happened to so the child could not be interviewed. Although the allegation may have happened or is true, based on a preponderance of evidence, the allegation has been deemed to be Inconclusive.
Inconclusive
Estimated Days of Completion:
SUPERVISOR'S NAME: Anita HiseTELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Alda AguirreTELEPHONE: (951) 218-5196
LICENSING EVALUATOR SIGNATURE:

DATE: 07/19/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2016
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 7



Control Number 09-CC-20160531161943
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 ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: V.I.P. TOTS
FACILITY NUMBER: 330909315
VISIT DATE: 07/19/2016
NARRATIVE
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An exit interview was conducted and a copy of this report was provided to the Executive Director Karen Calvillo on this date. Also, the Executive Director was provided a copy of their appeal rights (LIC9058) and their signature on this form acknowledges receipt of these rights.

A copy of this report must be made available to the public for 3 years.
SUPERVISOR'S NAME: Anita HiseTELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Alda AguirreTELEPHONE: (951) 218-5196
LICENSING EVALUATOR SIGNATURE:

DATE: 07/19/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2016
LIC9099 (FAS) - (06/04)
Page: 4 of 7


Control Number 09-CC-20160531161943

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 ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: V.I.P. TOTS
FACILITY NUMBER: 330909315
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/19/2016
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/03/2016
Section Cited
101212(e)(4)
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Reporting Requirements. The items below shall be reported to the Department within 10 working days following their occurrence: Any changes in the plan of operation that affect services to children. the facility submitted a Plan of Operation to Community Care Licensing stating that the facility would operate with a ratio of 4 children, to be supervised by 1 teacher for the toddler program
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Facility will submit an addendum to their current Plan of Operation no later than 8/3/16.
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and 8-10 children to 1 teacher in the preschool classroom. The facility has not operated within the ratios indicated on their license because the facility has operated a classroom of 17 preschool children, including special needs children with 2 staff members. At times, the classroom has 12 children supervised by one staff member, while another staff member prepares snacks and lunch.
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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: Anita HiseTELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Alda AguirreTELEPHONE: (951) 218-5196
LICENSING EVALUATOR SIGNATURE:

DATE: 07/19/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2016
LIC9099 (FAS) - (06/04)
Page: 6 of 7


Control Number 09-CC-20160531161943

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 ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: V.I.P. TOTS
FACILITY NUMBER: 330909315
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/19/2016
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/20/2016
Section Cited
H&S 1596.881
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Employees enforcement of law or refusal to violate law; discharge, demotion, or suspension; prohibition; notification of rights: No employer shall discharge, demote, or suspend, or threaten to discharge, demote, or suspend, or in any manner discriminate against any employee who takes any of the following actions: (a) Makes any
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The director will sit, one on one, with each staff member and will have the employees sign the newly dated Employee Rights Form. The director will also sign the form and submit a copy to CCL by 7/20/16.
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good faith oral or written complaint of the violation of any licensing or other laws by the employer to the State Department of Social Services or other agency having statutory responsibility for enforcement of the law or to the employer or representative of the employer. Karen Calvillo held a staff meeting where she reprimanded staff for file a complaint with CCL.
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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: Anita HiseTELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Alda AguirreTELEPHONE: (951) 218-5196
LICENSING EVALUATOR SIGNATURE:

DATE: 07/19/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2016
LIC9099 (FAS) - (06/04)
Page: 2 of 7



Control Number 09-CC-20160531161943
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 ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: V.I.P. TOTS
FACILITY NUMBER: 330909315
VISIT DATE: 07/19/2016
NARRATIVE
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Regulations, Title 22, Division 12, Chapter 1, is being cited on the attached LIC 9099D.

An exit interview was conducted and a copy of this report was provided to the Executive Director Karen Calvillo on this date. Also, the Executive Director was provided a copy of their appeal rights (LIC9058) and their signature on this form acknowledges receipt of these rights.

A copy of this report must be made available to the public for 3 years.
SUPERVISOR'S NAME: Anita HiseTELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Alda AguirreTELEPHONE: (951) 218-5196
LICENSING EVALUATOR SIGNATURE:

DATE: 07/19/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2016
LIC9099 (FAS) - (06/04)
Page: 5 of 7



Control Number 09-CC-20160531161943
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 ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: V.I.P. TOTS
FACILITY NUMBER: 330909315
VISIT DATE: 07/19/2016
NARRATIVE
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children with 2 staff members. At times, the classroom has 12 children supervised by one staff member, while another staff member prepares snacks and lunch. As a result of these ratios, the facility is operating out of ratio from what is in their own Plan of Operation and the facility failed to report the changes in the plan of operation that affect services to children within 10 days of makings the changes.

Therefore, based on LPAs observations and interviews conducted and a review of additional pertinent information obtained, the preponderance of evidence standard has been met, therefore the allegation that the facility is out of ration and/or in violation of their own Plan of Operation is found to be Substantiated. California Code of Regulations, Title 22, Division 12, Chapter 1, is being cited on the attached LIC 9099D.

Additionally, on 6/9/16, a visit was previously conducted, regarding the complaint, on that visit staff was interviewed and facility files were reviewed.

The following was alleged: Staff being threatened and/or intimidated after a previous complaint was substantiated, “a staff not having a criminal record clearance and a health screening on file.”

Licensing Program Analysts (LPAs) Lopez and Aguirre investigated the above allegation and gathered the following information: On 4/20/16, LPA Lopez conducted a visit, regarding a complaint. The complaint allegation was substantiated, which resulted in a Type “A” citation, along with the assessment of a $500.00 civil penalty for Criminal Record Clearance. After the visit from Licensing, the Executive Director Karen Calvillo called a meeting with all staff. Staff was asked what they would do with $500.00 and after a few suggestions from staff, according to information gathered, staff was told that those suggestions would not be possible. Staff was told that the reason this wouldn’t be possible was because someone called licensing and reported that Karen Calvillo was working at the facility without a fingerprint clearance, and that cost the facility $500.00. Staff were told that this was not a game and to act like adults. Finally, it was disclosed that Karen told the staff that they were either with her or against her and then she pointed at the door. As a result of this meeting, staff felt threatened, and are afraid to report any Title 22 regulation violations that arise at the facility, and in doing so this could result in the loss of employment.

Therefore, based on LPAs observations and interviews conducted and a review of additional pertinent information obtained, the preponderance of evidence standard has been met, therefore the allegation that staff were being threatened and/or intimidated after previous complaint is found to be Substantiated. California Code of
SUPERVISOR'S NAME: Anita HiseTELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Alda AguirreTELEPHONE: (951) 218-5196
LICENSING EVALUATOR SIGNATURE:

DATE: 07/19/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2016
LIC9099 (FAS) - (06/04)
Page: 7 of 7