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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334830147
Report Date: 01/11/2023
Date Signed: 01/11/2023 10:26:12 AM

Document Has Been Signed on 01/11/2023 10:26 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, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:YOUNG SCHOLAR EDUCATION CENTERFACILITY NUMBER:
334830147
ADMINISTRATOR:ROSA PEREZFACILITY TYPE:
850
ADDRESS:4029 W. GEORGE STREETTELEPHONE:
(951) 849-5608
CITY:BANNINGSTATE: CAZIP CODE:
92220
CAPACITY: 72TOTAL ENROLLED CHILDREN: 72CENSUS: 44DATE:
01/11/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Rosa PerezTIME COMPLETED:
10:30 AM
NARRATIVE
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A case management visit is being conducted in response to the receipt of an Unusual Incident Report (UIR) from the facility. The UIR was received by the licensing agency on 12/20/22 and a prior visit was conducted on 12/22/22. UIR states on 12/16/2022, a staff pulled a child’s hair. LPA met with Director, Rosa Perez to further discuss the incident.

Facility completed reporting requirements as required (telephone notification and submission of LIC624) to the Department and notified the authorized representative of the alleged child involved.

During the course of this investigation, LPA toured the facility, took census, reviewed/obtained records, obtained video footage, and conducted interviews with pertinent parties involved.

Staff interviews reported different information from what was reported in the UIR. Staff stated they did move a child from the floor to the table for safety as napping cots were being moved. Child interview denied staff pulled their hair. Written witness statements also reported conflicting information of the alleged incident.



LPA did not determine staff pulled a child’s hair; however, during the course of investigating the UIR, other evidenced revealed, during a facility presentation, a staff member did pull a child off stage by their arm/shirt, resulting in the child falling off balance and the staff having to assist child back into an upright position.

Based on the information gathered, the following violation has been identified: CCR 101223(a)(1)


Personal Rights: (1) To be accorded dignity in his/her personal relationships with staff and other persons. SEE LIC 809-D for the deficiency cited.

The Director was provided a copy of their appeal rights and their signature on this form acknowledges receipt of these rights. An exit interview was conducted; a copy of this report and Notice of Site Visit was provided to the Director. THIS REPORT MUST BE AVAILABLE TO THE PUBLIC UPON REQUEST FOR THREE YEARS.

SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Giselle Carbullido
LICENSING EVALUATOR SIGNATURE: DATE: 01/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/11/2023
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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Document Has Been Signed on 01/11/2023 10:26 AM - It Cannot Be Edited


Created By: Giselle Carbullido On 01/11/2023 at 10:11 AM
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 ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: YOUNG SCHOLAR EDUCATION CENTER
FACILITY NUMBER: 334830147

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/11/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/17/2023
Section Cited
CCR
101223(a)(1)

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Personal rights: 101223(a):(1) To be accorded dignity in his/her personal relationships with staff and other persons.

This requirement is not met as evidenced by:
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Facility Director agrees to complete retraining with staff on CCR 101223(a)(1) and will send in training materials covered and letter of understanding for 101223(a)(1) by POC due date 01/17/2023.
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Based on evidenced gathered the section above was not met in that staff pulled a child by the arm/shirt resulting in child falling off balance. This is a potential health and safety 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:Gilbert Sena
LICENSING EVALUATOR NAME:Giselle Carbullido
LICENSING EVALUATOR SIGNATURE:
DATE: 01/11/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/11/2023


LIC809 (FAS) - (06/04)
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