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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364805925
Report Date: 02/07/2024
Date Signed: 02/07/2024 11:04:30 AM

Document Has Been Signed on 02/07/2024 11:04 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:RIALTO U.S.D. BOYD ELEMENTARY SCHOOLFACILITY NUMBER:
364805925
ADMINISTRATOR:GOOD, KARENFACILITY TYPE:
850
ADDRESS:310 E. MERRILL AVENUE J-2TELEPHONE:
(909) 820-7929
CITY:RIALTOSTATE: CAZIP CODE:
92376
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 22DATE:
02/07/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Lead Teacher, Sonya DuranTIME COMPLETED:
11:10 AM
NARRATIVE
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On this date and time, Licensing Program Analyst (LPA) Laura Mejorado arrived at the facility to conduct a case management visit in response to the receipt of an unusual incident report (UIR). The UIR was received by the licensing agency on 02/02/24. The UIR documented an incident involving a child being released to an unauthorized representative. Upon arrival, LPA met with lead teacher Sonya Duran and stated the purpose of the visit. Records were reviewed and interviews were conducted.

On 02/02/24 facility staff released a child to a relative who was no longer listed as an authorized representative to pick up the child as of 11/01/23. The child's authorized representative arrived shortly after the child was released and was informed the child had already left with another relative. The authorized representative was upset and stated that relative was no longer listed as an authorized individual who can pick up. Staff stated they recognized the relative who also had the child's siblings and the child was excited to see them and the child was released based on the staff member recognizing the relative. However, that emergency card had been updated to remove the relative and staff stated they were unaware of the change. The Early Education Administrator (EEA) contacted the authorized representative and apologized for what happened and asked if the child was safe. The authorized representative stated the child was safe but that they did not want this to happen again. The EEA verified the individuals listed on the child's updated emergency card with the authorized representative who confirmed it was correct. The EEA also spoke to staff and ensured everyone is aware of the update and went over the importance of pick-up procedures.

On 02/05/24 Staff stated the child returned as normal and was dropped off by their other authorized representative, staff apologized again and authorized representative stated it was ok but to make sure it doesn't happen again.

SUPERVISORS NAME: Kimberly Williams
LICENSING EVALUATOR NAME: Laura Mejorado
LICENSING EVALUATOR SIGNATURE: DATE: 02/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/07/2024
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 02/07/2024 11:04 AM - It Cannot Be Edited


Created By: Laura Mejorado On 02/07/2024 at 09:54 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: RIALTO U.S.D. BOYD ELEMENTARY SCHOOL
FACILITY NUMBER: 364805925

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/07/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/09/2024
Section Cited
CCR
101173(d)

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Plan of Operation - The child care center shall operate in accordance with the terms specified in the plan of operation. This requirement has not been met as evidenced by:
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Facility staff understand the importance of following the Facility's plan of operations especially pertaining to the release of a child to an unauthorized representative. A training will be conducted with staff members regarding the release of a child and proper steps to take to verify identification.
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Based on interviews conducted, staff did not act in accordance with its plan of operation. On 02/02/24 staff released a child to an unauthorized representative who was no longer listed on the child’s emergency card, which poses a potential health, safety or personal rights risk to persons in care.
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Documentation of training/proof of correction will need to be submitted to LPA on or before the date of correction, 02/09/24.

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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:Kimberly Williams
LICENSING EVALUATOR NAME:Laura Mejorado
LICENSING EVALUATOR SIGNATURE:
DATE: 02/07/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/07/2024


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: RIALTO U.S.D. BOYD ELEMENTARY SCHOOL
FACILITY NUMBER: 364805925
VISIT DATE: 02/07/2024
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Based on the information gathered, staff released a child to a relative who was no longer listed as an authorized representative to pick up the child, which is a violation of California Code of Regulations, Title 22. See LIC809D for cited deficiency.

A notice of site visit was given and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

Exit interview conducted and report was reviewed with Lead Teacher, Sonya Duran.

SUPERVISORS NAME: Kimberly Williams
LICENSING EVALUATOR NAME: Laura Mejorado
LICENSING EVALUATOR SIGNATURE:

DATE: 02/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2024
LIC809 (FAS) - (06/04)
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