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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364843060
Report Date: 11/22/2022
Date Signed: 11/22/2022 02:57:43 PM

Document Has Been Signed on 11/22/2022 02:57 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:FOOTHILL CHILD DEVELOPMENT CENTERFACILITY NUMBER:
364843060
ADMINISTRATOR:PAULINE COPASFACILITY TYPE:
850
ADDRESS:791 E. FOOTHILL BLVD. UNIT BTELEPHONE:
(909) 985-4448
CITY:UPLANDSTATE: CAZIP CODE:
91786
CAPACITY: 74TOTAL ENROLLED CHILDREN: 74CENSUS: 32DATE:
11/22/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Pauline CopasTIME COMPLETED:
03:15 PM
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On 11/22/22 a follow up case management inspection is being conducted by License Program Analysts (LPAs) Blanca Ruiz and Elyse Jones in response to the receipt of an unusual incident report ( UIR) from the facility.  LPAs met with Director, Pauline Copas.  The center was toured, and a census was taken.

During the process of the investigation, records were reviewed and interviews were conducted with pertinent parties. UIR indicates that a police officer came to the center to conduct a wellness check regarding and incident pertaining to Staff #1 who accidentally scratched Child #1 with her/his ring when child resisted to sit down during a classroom activity and threw her/himself down to the ground. Child sustained a scratched on the right arm under biceps. Parent(s)/Legal guardian(s) was informed of the incident.

A meeting with the parent(s), staff, child was held at the facility to work on a plan to meet child's needs and/or to prevent any future incidents from occurring.  Staff#1 is no longer employed by the facility and child was not available to be interview.

Based on information gathered, the facility acted appropriately and no violations have been identified pertaining to this incident at this time.

An exit interview was conducted and a copy of this report was provided to facility staff. A Notice of Site visit was issued and shall remain posted for the next 30 days. A copy of this report must be made available to the public, at the facility site, for 3 years.
SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Blanca Ruiz-Silva
LICENSING EVALUATOR SIGNATURE: DATE: 11/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/22/2022
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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