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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334840189
Report Date: 12/19/2024
Date Signed: 12/19/2024 10:00:27 AM

Document Has Been Signed on 12/19/2024 10:00 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
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:CANYON LAKE COMMUNITY CHURCH PRESCHOOLFACILITY NUMBER:
334840189
ADMINISTRATOR/
DIRECTOR:		BRITTANY YOUNGQUISTFACILITY TYPE:
850
ADDRESS:30515 RAILROAD CANYON ROADTELEPHONE:
(951) 244-1877
CITY:CANYON LAKESTATE: CAZIP CODE:
92587
CAPACITY: 73TOTAL ENROLLED CHILDREN: 73CENSUS: 0DATE:
12/19/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Brittany Youngquist, DirectorTIME VISIT/
INSPECTION COMPLETED:
10:10 AM
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On Thursday, December 19, 2024 Licensing Program Analyst (LPA) Jesse Gardner conducted an unannounced Case Management inspection to follow-up on an Unusual Incident Report (UIR) submitted to Community Care Licensing CCL on December 3, 2024. LPA met with Director Brittany Youngquist and toured the facility.

On December 3, 2024, CCL received information via UIR that Child One (C1) was playing with a ball on artificial turf when they were bumped into by another child. When this occurred, C1 fell onto a short wall that separates the playground from the covered pavilion. C1 had hit their head as a result of the incident. Staff believe that C1 may have been stunned and/or unconscious for a split second by the way they were observed when they fell to the ground. Staff 1 (S1), and Staff 2 (S2) were on the playground witnessed the incident, and got to C1 within a matter of seconds and noticed that C1 was breathing, and alert. Ratio was reported to be 2 teachers to 13 children at the time of incident. C1's parents were advised of the incident, and C1's mother arrived and took C1 to the hospital at the advice of staff. Upon exit from the hospital, C1's mother relayed that C1 was observed for a few hours, and then sent home with no orders from the doctor. C1 returned to the center the following day with normal observations. Since then, staff relayed that children will not be playing any chase/catch game on the artificial turf.

Interviews conducted and LPA observation of the incident via video footage revealed to LPA that proper and timely aid was provided to the injured child concluding the incident. In addition, the incident was reported to CCL and documentation observed in the injured child’s file and parents were notified. Records review also confirmed that the CCC was operating within proper staff to child ratios. Based on information gathered, the CCC acted appropriately and no violations of Title 22 have been identified.

An exit interview was held with Brittany Youngquist. A copy of this report was issued, along with a Notice of Site visit. This report shall be public record for three years.
SUPERVISORS NAME: Deborah Mullen
LICENSING EVALUATOR NAME: Jesse Gardner
LICENSING EVALUATOR SIGNATURE: DATE: 12/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/19/2024
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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