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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334840528
Report Date: 02/28/2024
Date Signed: 02/28/2024 12:14:54 PM

Document Has Been Signed on 02/28/2024 12:14 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
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:LEUSD WILLIAM COLLIER PRESCHOOLFACILITY NUMBER:
334840528
ADMINISTRATOR:ADRIA GALARZAFACILITY TYPE:
850
ADDRESS:20150 MAYHALL DRIVETELEPHONE:
(951) 253-7630
CITY:WILDOMARSTATE: CAZIP CODE:
92595
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 20DATE:
02/28/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:25 AM
MET WITH:Claudia Leon, Family Engagement SupervisorTIME COMPLETED:
12:34 PM
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On February 28, 2024, at 10:30 am, Licensing Program Analyst (LPA) Cindy Hamilton arrived at LEUSD - William Collier Elementary to conduct a case management visit. 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 02/08/2024. LPA met with Claudia Leon and advised of the reason for the visit. The UIR indicates a child fractured their right foot when the cabinet the child climbed up on fell on the child.

Confidential interviews revealed that the child had been climbing on the shelf prior to the incident and instructed to not climb on the shelf. In addition, facility provided the appropriate aid to the injured child, contacted parents immediately and reported incident timely to CCL via UIR. 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 conducted with Claudia Leon. A copy of this report and appeal rights were issued, along with a Notice of Site visit. This report shall be public record for three years.
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Cindy Hamilton
LICENSING EVALUATOR SIGNATURE: DATE: 02/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/28/2024
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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