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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 364815206
Report Date: 06/28/2021
Date Signed: 08/23/2021 03:54:37 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/25/2021 and conducted by Evaluator Aaron Mabika
COMPLAINT CONTROL NUMBER: 12-CC-20210525143847
FACILITY NAME:MC DONALD LEARNING CENTERFACILITY NUMBER:
364815206
ADMINISTRATOR:MERCY VALENCIAFACILITY TYPE:
850
ADDRESS:1017 HOLDEN AVENUETELEPHONE:
(909) 585-6848
CITY:BIG BEAR CITYSTATE: CAZIP CODE:
92314
CAPACITY:60CENSUS: 56DATE:
06/28/2021
UNANNOUNCEDTIME BEGAN:
12:27 PM
MET WITH:Lisa BurtnerTIME COMPLETED:
01:50 PM
ALLEGATION(S):
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Personal Rights
INVESTIGATION FINDINGS:
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This report is being amended from the report dated 06/28/2021. Licensing Program Analyst (LPA) Mabika met with the Licensee, Lisa Burtner, for the purpose of concluding the complaint investigation related to the above allegation. LPA disclosed the purpose of the inspection and was granted entry. A tour of the whole facility was conducted.
Present during today’s inspection were 5 Infants with 3 staff, 41 preschoolers with 6 staff and 10 school age children with 1 staff.
Child # 1 was scratched by Child # 3 resulting in Child # 1 sustaining a bruise. Based on the information obtained staff was present, however, were unable to prevent the incident from happening resullting in child # 1 sustaining stratches. It was revealed during the course of the investgation that Child # 1's Personal Rights were violated and Licensee failed to report to parent of Child # 1 and CCL of other incidents of Child # 1 and # 2. The preponderance of evidence has been met; therefore, the above allegations have been substantiated.
Type "A" and "B" Deficiencies cited, see LIC 9099D.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Aaron Mabika
LICENSING EVALUATOR SIGNATURE:

DATE: 08/23/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 4
Control Number 12-CC-20210525143847
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: MC DONALD LEARNING CENTER
FACILITY NUMBER: 364815206
VISIT DATE: 06/28/2021
NARRATIVE
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Licensee was advised that the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days. A copy of this licensing report (LIC9099) must also be posted for 30 days. If these requirements are not met, civil penalties in the amount of $100 per violation will be assessed. Copies of the reports must also be provided to each parent and a copy of the Acknowledgment of receipt of licensing report (LIC9224) must be kept in each child's file. In addition, any child enrolled within the following 12 months must also receive a copy of the Type A Citation.

An exit interview was conducted, a copy of this report, and notice of site visit were provided to Licensee, Lisa Burtner.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Aaron Mabika
LICENSING EVALUATOR SIGNATURE:

DATE: 08/23/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 12-CC-20210525143847
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: MC DONALD LEARNING CENTER
FACILITY NUMBER: 364815206
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/28/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/28/2021
Section Cited
HSC
101223(a)(2)(3)
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101223 Personal Rights
(a) The licensee shall ensure that each child is accorded the following personal rights:
(2) To be accorded safe,....
3) To be free from..., infliction of pain, ..., threat, mental abuse or other actions of a .3) To be free from..., infliction of pain, ...,
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Licensee shall provide a plan of correction on how staff will ensure all children are supervised at all times. This POC shall be provided to the RO within 24 hours.
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This requirement was not met as evidenced by; a child #1 was scratched by child #3 while in care resulting child # 1 sustaining scratches and a bruise.
This is a Type A violation and it poses an immediate risk to the health and safety of 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.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Aaron Mabika
LICENSING EVALUATOR SIGNATURE:

DATE: 08/23/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2021
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 12-CC-20210525143847
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: MC DONALD LEARNING CENTER
FACILITY NUMBER: 364815206
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/28/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/13/2021
Section Cited
HSC
101212(d)(2)
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101212 Reporting Requirements
(d) Upon the occurrence,.. any of the events specified in (d)(1) below, a report shall be made to the Department by telephone or fax ...report containing the information specified in (d)(2) below shall be submitted to the Department within seven days...
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Licensee shall draw up a Plan of Correction detailing how the responsible party shall be informed in a timely manner. This shall be submitted to the department by 07/13/2021
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This requirement was not met as evidenced by the failure to swiftly inform Child # 1 parents and CCL.
This poses a potential danger to the health and safety of 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.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Aaron Mabika
LICENSING EVALUATOR SIGNATURE:

DATE: 08/23/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2021
LIC9099 (FAS) - (06/04)
Page: 4 of 4