<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 364846072
Report Date: 02/06/2024
Date Signed: 02/06/2024 04:39:35 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
INLAND EMPIRE CHILD, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/21/2023 and conducted by Evaluator Rachel Zeron
COMPLAINT CONTROL NUMBER: 09-CC-20231221170520
FACILITY NAME:EVERBROOK ACADEMYFACILITY NUMBER:
364846072
ADMINISTRATOR:VAN DUZER, MARGARET GALEFACILITY TYPE:
850
ADDRESS:3040 CHINO AVETELEPHONE:
(909) 591-7574
CITY:CHINO HILLSSTATE: CAZIP CODE:
91709
CAPACITY:168CENSUS: 104DATE:
02/06/2024
UNANNOUNCEDTIME BEGAN:
03:30 PM
MET WITH:Margaret Gale Van Duzer - Director TIME COMPLETED:
05:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9

Staff did not allow a child in care access to the bathroom.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On the above date and time, Licensing Program Analyst (LPA) Rachel Zeron, arrived at the facility for the purpose of continuing and complaint investigation and to deliver findings regarding the above allegation. The LPA was greeted by Director Gale Van Duzer and granted entry to tour the facility inside and out. The LPA took a census of 104 children in care.
On 12/29/2023 the complaint investigation was initiated by LPA Susan Brewer, regarding a Personal Rights allegation. LPA reviewed facility records and conducted interviews pertinent to the investigation, however more time was needed to continue the investigation. During today's investigation the LPA Rachel Zeron, met with Director Margaret G.Van Duzer to discuss the above allegation.

It was alleged that facility staff did not allow a subject child in care access to the bathroom, when a subject child pulled on the bathroom door, motioning to staff their need to enter. Information gathered through record review and interviews with pertinent parties revealed the licensee confirmed by text communication with the authorized representative, that an incident occurred in December 2023, which resulted in the subject child accidentally peeing on themselves.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Rachel Zeron
LICENSING EVALUATOR SIGNATURE:

DATE: 02/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2024
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 3
Control Number 09-CC-20231221170520
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
INLAND EMPIRE CHILD, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: EVERBROOK ACADEMY
FACILITY NUMBER: 364846072
VISIT DATE: 02/06/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Based on LPA interviews which were conducted and record reviews, the licensee’s admission that facility staff did not allow a child in care access to the bathroom, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED.
A California Code of Regulations, Title 22, 101223(a)(2) Personal Rights is being cited on the attached LIC 9099D.

LPA Rachel Zeron, informed licensee Director Gale Van Duzer that this report dated 02/06/2024 documents 101223(a)(2) Personal Rights, Type A citation(s) which shall be posted for 30 consecutive days as there is immediate risk to the health, safety, or personal rights of children in care. A civil penalty was issued for this violation.

Also, LPA Rachel Zeron, informed the licensee Gale Van Duzer to provide a copy of this licensing report dated 02/06/204 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report LIC 9224, or other written statement, must be placed in the child's file for verification.
SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Rachel Zeron
LICENSING EVALUATOR SIGNATURE:

DATE: 02/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 09-CC-20231221170520
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
INLAND EMPIRE CHILD, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: EVERBROOK ACADEMY
FACILITY NUMBER: 364846072
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/06/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/07/2024
Section Cited
CCR
101223(a)(2)
1
2
3
4
5
6
7
Personal Rights: (a). The licensee shall ensure that each child is accorded the following personal rights:(2) To be accorded safe, healthful, and comfortable accommodations, furnishings and equipment to meet his/her needs. This requirement is not being met as evidenced by:
1
2
3
4
5
6
7
Director agrees to have a meeting with staff to discuss the importance of children's cues to use the restroom or other neccesities of the the children in care. Director will submit the itinerary and roster for the teachers in attendance to Licensing by POC date.
8
9
10
11
12
13
14
According to interviews conducted a child was not taken to the restroom therefore having a potty accident while in care.

This poses an immediate health, safety or personal rights risk to persons in care.
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: Aaron Ross
LICENSING EVALUATOR NAME: Rachel Zeron
LICENSING EVALUATOR SIGNATURE:

DATE: 02/06/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3