334844315-2-14-2023-09-CC-EJOS-CP2SGW-20230214125238

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 334844315
Report Date: 02/14/2023
Date Signed: 02/14/2023 12:52:46 PM

Document Has Been Signed on 02/14/2023 12:52 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 ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME:	QCS JOY STREET CHILD DEVELOPMENT CENTER		FACILITY NUMBER:	334844315
ADMINISTRATOR:	OLGA RUELAS		FACILITY TYPE:	850
ADDRESS:	224 SOUTH JOY STREET		TELEPHONE:	(760) 942-3433
CITY:	CORONA	STATE: CA	ZIP CODE:	92879
CAPACITY: 47	TOTAL ENROLLED CHILDREN: 47	CENSUS: 37	DATE:	02/14/2023
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME BEGAN:	09:25 AM
MET WITH:	Bertha Fregoso, Site Supervisor		TIME COMPLETED:	01:00 PM

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Licensing Program Analysts (LPAs) Elyse Jones and Blanca Ruiz arrived at the facility to conduct a Case Management-Incident inspection in response to the receipt of an Unusual Incident Report (UIR) from the facility. It was noted, while playing outside on the playground Child #1 was running, tripped over his/her own feet, fell and sustained a broken arm. At the time of the incident two qualified teachers were present with 14 children. Appropriate supervision and care was being provided. The facility notified the Authorized Representative (AR) immediately after the incident occurred and an Incident Report was provided at pick up.

At the time of the inspection, LPAs toured the facility, took census, and met with Site Supervisor, Bertha Fregoso. Interviews with pertinent parties were conducted to obtain details regarding the reported incident and documentation was collected. During the facility tour the area in which the incident occurred was observed.

Child #1 did not return to the facility the following day which prompted the Site Supervisor to contact the AR. During the phone call the AR informed the Site Supervisor that Child #1 was taken to a local hospital for evaluation and was diagnosed with a broken arm. Child #1 returned on February 6, 2023.

SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Elyse Jones
LICENSING EVALUATOR SIGNATURE:	DATE: 02/14/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2023

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: QCS JOY STREET CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 334844315
	VISIT DATE: 02/14/2023

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Based on the information gathered, the incident was an accident as facility staff followed care and supervision protocols. First Aid was provided, the AR was immediately notified of the incident and Licensing was notified within the time frame set forth in the Title 22 regulations. Facility acted appropriately and was found to be in substantial compliance during this inspection.

An exit interview was conducted, a copy of this report and a Notice of Site Visit was provided to facility Site Supervisor, Bertha Fregoso.

A copy of this report must be made available to the public, at the facility site, for 3 years.

Notice of Site Visit must be posted for 30 days.

SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Elyse Jones
LICENSING EVALUATOR SIGNATURE:	DATE: 02/14/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2023

LIC809 (FAS) - (06/04)

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