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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 330910580
Report Date: 12/09/2024
Date Signed: 12/09/2024 01:42:59 PM

Document Has Been Signed on 12/09/2024 01:42 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:LEUSD MACHADO PRESCHOOLFACILITY NUMBER:
330910580
ADMINISTRATOR/
DIRECTOR:		STEVE BEHARFACILITY TYPE:
850
ADDRESS:15150 JOY STREETTELEPHONE:
(951) 253-7662
CITY:LAKE ELSINORESTATE: CAZIP CODE:
92530
CAPACITY: 82TOTAL ENROLLED CHILDREN: 82CENSUS: 35DATE:
12/09/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:50 AM
MET WITH:Claudia Leon, SupervisorTIME VISIT/
INSPECTION COMPLETED:
02:15 PM
NARRATIVE
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On December 9, 2024, at 10:45 am, Licensing Program Analysts (LPA) William Chancellor arrived unannounced to the facility for a case management visit, to follow up on an unusual incident report (UIR) dated 11/7/24. LPA was greeted by the LEUSD school principal and the site Supervisor (S2), Claudia Leon was contacted. Upon arrival, S2 was notified of reason for case management visit.

The facility self reported that staff (S1) witnessed staff (S4) mishandling of students. The UIR additionally reported, S4 was witnessed yelling and being forceful with students during nap time. LPA interviewed Supervisor, (S2) Claudia Leon, two additional staff that witnessed (S1 and S2) and LPA attempted to interview child (C1). The interview with S2 revealed S4 was placed on Administrative Leave immediately after being notified of the incident. LPA confirmed that S4 is no longer associated to the facility as of 11/7/24.

The facility is being cited for Title 22 Regulation Section 101223 (a)(3). See LIC 809D for cited deficiency.

An exit interview was conducted, a copy of this report and appeal rights were reviewed and provided to Supervisor Claudia Leon. A notice of site visit was also provided and must remain posted for 30 days.
SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: William M Chancellor Jr.
LICENSING EVALUATOR SIGNATURE: DATE: 12/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/09/2024
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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Document Has Been Signed on 12/09/2024 01:42 PM - It Cannot Be Edited


Created By: William M Chancellor Jr. On 12/09/2024 at 01:23 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
, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: LEUSD MACHADO PRESCHOOL
FACILITY NUMBER: 330910580

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/09/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/09/2025
Section Cited
CCR
101223(a)(3)

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(a) The licensee shall ensure that each child is accorded the following personal rights: (3) To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature...
This requirement was not met as evidenced by:
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Supervisor will email LPA supporting documentation from Mental Health Supervisor and Instructional Coach on supervision and redirection training for all staff including personal rights and reporting requirements. LPA confirmed that S4 is no longer associated to LEUSD as of 11/7/24.
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Based on three of three interviews and record review, it was confirmed that C1 was forcefully grabbed and yelled at by S4. Which poses a potential health, safety and 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.
SUPERVISOR'S NAME:Pauline Beschorner
LICENSING EVALUATOR NAME:William M Chancellor Jr.
LICENSING EVALUATOR SIGNATURE:
DATE: 12/09/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/09/2024


LIC809 (FAS) - (06/04)
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