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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 364846073
Report Date: 12/15/2022
Date Signed: 12/15/2022 01:53:13 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
11/28/2022 and conducted by Evaluator Rachel Zeron
PUBLIC
COMPLAINT CONTROL NUMBER: 09-CC-20221128171936
FACILITY NAME:EVERBROOK ACADEMY, LLC DBA PRESTIGE PRESCH ACADFACILITY NUMBER:
364846073
ADMINISTRATOR:VAN DUZER, MARGARET GALEFACILITY TYPE:
830
ADDRESS:3040 CHINO AVETELEPHONE:
(909) 591-7574
CITY:CHINO HILLSSTATE: CAZIP CODE:
91709
CAPACITY:28CENSUS: 17DATE:
12/15/2022
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Gale Van DuzerTIME COMPLETED:
02:00 PM
ALLEGATION(S):
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Staff did not ensure child was given milk at meal
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Rachel Zeron arrived at the facility continue an investigation initiated on 11/28/2022. Upon arriving LPA met with Gale Van Duzer, Director to discuss the outcome of the investigation pertaining to the above allegation. LPA toured and took census.


During initial visit, LPA conducted interviews with staff and other pertinent individuals and conducted a records review. Based on interviews conducted, it was revealed that the classrooms have cameras that the responsible parties of children in care are able to access on the facility app, "Sprout About". It was alleged that a child was not given milk or offered assistance eating at meal time. According to interviews with staff, it was revealed that the facility was not following Infant feeding plan which indicated that the child required assistance eating and requires milk after all meals. Due to the child's age, the ability to communicate needs was limited.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Rachel Zeron
LICENSING EVALUATOR SIGNATURE:

DATE: 12/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2022
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 5
Control Number 09-CC-20221128171936
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, LLC DBA PRESTIGE PRESCH ACAD
FACILITY NUMBER: 364846073
VISIT DATE: 12/15/2022
NARRATIVE
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Based upon the information gathered, the preponderance of evidence standard has been met, and therefore, the above allegations are found to be SUBSTANTIATED.

See LIC 9099D for deficiency cited.

An exit interview was conducted, and a copy of this report was reviewed and provided to the Director, Gale Van Duzer. Appeal rights were discussed and provided during the exit interview.
A notice of site visit was given and must remain posted for 30 days.

Licensee must have parents of all current and any newly enrolled clients within the next 12 months, complete the Parent Notification Requirements form LIC 9224, and place the completed form in the child’s facility file. A civil penalty of $100 per violation will be assessed for noncompliance.
SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Rachel Zeron
LICENSING EVALUATOR SIGNATURE:

DATE: 12/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 09-CC-20221128171936
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, LLC DBA PRESTIGE PRESCH ACAD
FACILITY NUMBER: 364846073
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/15/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/16/2022
Section Cited
CCR
101427(c)
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Infant care food service: The infant shall be fed in accordance with the individual plan


he requirement was not met as evidenced by:
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Director has implemented a plan in the toddler's classroom assigning teachers to a group of primary children. The teacher is responsible for the needs of the assigned children. Director agreed to write a letter of understanding of the pan that is implemented. Director will send the plan by POC date
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Based on interviews conducted and records review, facility was not following individual food service plan for infant in care.
This poses a immediate health, safety or personal rights risk to persons 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: Aaron Ross
LICENSING EVALUATOR NAME: Rachel Zeron
LICENSING EVALUATOR SIGNATURE:

DATE: 12/15/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 5
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
11/28/2022 and conducted by Evaluator Rachel Zeron
COMPLAINT CONTROL NUMBER: 09-CC-20221128171936

FACILITY NAME:EVERBROOK ACADEMY, LLC DBA PRESTIGE PRESCH ACADFACILITY NUMBER:
364846073
ADMINISTRATOR:VAN DUZER, MARGARET GALEFACILITY TYPE:
830
ADDRESS:3040 CHINO AVETELEPHONE:
(909) 591-7574
CITY:CHINO HILLSSTATE: CAZIP CODE:
91709
CAPACITY:20CENSUS: 17DATE:
12/15/2022
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Gale Van DuzerTIME COMPLETED:
02:00 PM
ALLEGATION(S):
1
2
3
4
5
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7
8
9


Staff did not provide drinking water to child in care.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Rachel Zeron arrived at the facility continue an investigation initiated on 11/28/2022. Upon arriving LPA met with Gale Van Duzer, Director to discuss the outcome of the investigation pertaining to the above allegation. LPA toured and took census.


During the investigation, LPA made observations, conducted interviews with staff and all other relevant individuals pertinent to this investigation. It is alleged that staff did not provide water to child in care, LPA observed the drinking water in a Brita filter dispenser and individual water bottles on the counter out of reach of the children. Since communication is limited for the age range and based on interviews conducted, LPA was unable to corroborate the allegation. Therefore, due to conflicting information found throughout this investigation this agency has investigated the complaint alleged is UNSUBSTANTIATED at this time. Although the allegation may have happened, or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur.

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Rachel Zeron
LICENSING EVALUATOR SIGNATURE:

DATE: 12/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 09-CC-20221128171936
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, LLC DBA PRESTIGE PRESCH ACAD
FACILITY NUMBER: 364846073
VISIT DATE: 12/15/2022
NARRATIVE
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An exit interview was conducted, and a copy of this report was reviewed and provided to the Director, Gale Van Duzer. Appeal rights were discussed and provided during the exit interview.

Director was reminded that the notice of site visit must remain posted for the next 30 days.
SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Rachel Zeron
LICENSING EVALUATOR SIGNATURE:

DATE: 12/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2022
LIC9099 (FAS) - (06/04)
Page: 5 of 5