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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 364846174
Report Date: 08/05/2022
Date Signed: 12/09/2022 09:53:07 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
06/24/2022 and conducted by Evaluator Blanca Ruiz-Silva
PUBLIC
COMPLAINT CONTROL NUMBER: 09-CC-20220624120417
FACILITY NAME:FAIRYTALE CASTLE PRESCHOOLFACILITY NUMBER:
364846174
ADMINISTRATOR:ROSA LOPEZFACILITY TYPE:
850
ADDRESS:710 EAST FOOTHILL BLVDTELEPHONE:
(626) 567-5678
CITY:UPLANDSTATE: CAZIP CODE:
91786
CAPACITY:116CENSUS: 0DATE:
08/05/2022
UNANNOUNCEDTIME BEGAN:
11:35 AM
MET WITH:Vicky Wei, Laura Perez and Juan WuTIME COMPLETED:
03:15 PM
ALLEGATION(S):
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Facility operating out of ratio.
INVESTIGATION FINDINGS:
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****AMENDED REPORT**** This is an amended report appeal granted on 11/22/22 findings change from substantiated to unsubstantiated.
Licensing Program Analyst (LPA) Blanca Ruiz arrived at the facility to discuss and deliver findings of the investigation for the above allegation(s). A 10 day inspection was initiated by LPA Ruiz on 06/29/2022. LPA met with Administrator, Vicky Wei, Director, Laura Perez and Teacher Juan Wu to provide finding related to the above allegations. This inspection was conducted in Chinese with the assistance of Translator/Teacher Ms. Juan Wu. No children were present due to Teachers in Service Day.
The following was discussed with administrator:
During the process of the investigation, records were reviewed, and interviews were conducted with pertinent parties. It was reported that facility was/ is operating out of ratio. Per pertinent parties who witness incident(s); it was stated that on or about the month of 06/2022, the facility has been operating out of ratio. According to information reported, one of the classrooms at the facility (2-3 years old) was observed with one qualify teacher and volunteers supervising 14-20 children. Teacher to child ratio 1:12; however, it was also reported that occasionally children were left alone under the supervision of different volunteers when lead teacher had to step away from the classroom in more than one occasion.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Blanca Ruiz-Silva
LICENSING EVALUATOR SIGNATURE:

DATE: 08/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2022
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-20220624120417
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: FAIRYTALE CASTLE PRESCHOOL
FACILITY NUMBER: 364846174
VISIT DATE: 08/05/2022
NARRATIVE
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LPA investigated the above allegation and gathered the following information throughout this investigation.
Information and documentation collected indicates that one fully qualify teacher and 1-3 volunteers were supervising up to 20 children during the month of 06/2022. According to records reviewed, qualified volunteers have 6 Early Childhood Education units and are able to work as a Teacher Assistant with a fully qualified teacher; however, volunteers are not included in the center's staffing plan and they should never be alone in the classroom without the direct supervision of a qualify teacher.
Facility administrator and staff denied all allegations and acknowledged having qualified volunteers in the classrooms observing and assisting with preschool activities. Administrator and staff stated that volunteers have never been left alone with the children if a qualify teacher is not present. Facility records obtained were unclear regarding facility operating out of ratio during the month of June 2022.

Based on the information obtained during the course of the investigation, there is conflicting information regarding the allegation. Although allegations may have happened or are valid, there is no preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore allegations are deemed Unsubstantiated at this time.

An exit interview was conducted with Acting Director/Administrator, Vicky Wei, appeal rights discussed. Licensees understands that the Notice of Site Visit must remain posted for the next 30 days.

A copy of this report was provided to the licensee on this date. THIS REPORT MUST BE AVAILABLE TO THE PUBLIC FOR THREE YEARS.
SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Blanca Ruiz-Silva
LICENSING EVALUATOR SIGNATURE:

DATE: 08/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Citations on this Visit Report are Under Appeal!

Control Number 09-CC-20220624120417
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: FAIRYTALE CASTLE PRESCHOOL
FACILITY NUMBER: 364846174
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/05/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Under Appeal
Type A
CCR
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****AMENDED REPORT**** This is an amended report appeal granted to change findings from substantiated to unsubstantiated. Deficiency has been dismissed.
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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: Blanca Ruiz-Silva
LICENSING EVALUATOR SIGNATURE:

DATE: 08/05/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 5