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

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 364846174
Report Date: 01/23/2024
Date Signed: 01/23/2024 10:38:17 AM

Substantiated


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
12/14/2023 and conducted by Evaluator Patricia Berry
PUBLIC
COMPLAINT CONTROL NUMBER: 09-CC-20231214111857
FACILITY NAME:FAIRYTALE CASTLE PRESCHOOLFACILITY NUMBER:
364846174
ADMINISTRATOR:DIANNE TALENSFACILITY TYPE:
850
ADDRESS:710 EAST FOOTHILL BLVDTELEPHONE:
(626) 567-5678
CITY:UPLANDSTATE: CAZIP CODE:
91786
CAPACITY:116CENSUS: 41DATE:
01/23/2024
UNANNOUNCEDTIME BEGAN:
08:10 AM
MET WITH:Dianne Talens/directorTIME COMPLETED:
10:55 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff roughly handled child in care
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 1/23/2024 at 8:10 am, Licensing Program Analyst (LPA) Patricia Berry conducted a subsequent complaint investigation to deliver final findings. LPA met with Dianne Talens and was granted access into the facility. LPA toured the facility and took a census. LPA reviewed and obtained documents.

Allegation: Staff roughly handled child in care

During the investigation, LPA interviewed all pertinent parties, including staff, and obtained/reviewed video of the incident. Staff stated they do not handle children roughly.LPA obtained and viewed video of the incident. In the video, a staff member removed a child from the top of a table. The staff member walked over to the table where the child was sitting on top of and picked the child up from underneath the child’s arms at first.

(Cont on 9099C)
Substantiated
Estimated Days of Completion: 0
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Patricia Berry
LICENSING EVALUATOR SIGNATURE:

DATE: 01/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2024
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-20231214111857
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: 01/23/2024
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
The child began to wiggle, so the staff member began to hold the child by their arms. The staff member walked the child to a cot, and while the staff member was in a standing position, dropped the child on the cot. After the child’s body dropped on the cot, there was a bang noise, and a child began to cry.

The incident was also investigated by local law enforcement. Law enforcement interviewed staff and reviewed video of the incident. Law enforcement confirmed the incident occurred and their report was sent to the District Attorney’s office for review.


Based on LPA’s video review of the incident and interviews conducted, the preponderance of evidence standard has been met; therefore, the above allegation is found to be substantiated. California Code of Regulations, (Title 22, divisions & chapter number) are being cited on the attached LIC 9099D.

An exit interview was conducted, a copy of this report was provided to director, appeal rights were discussed and provided, and a copy of the Acknowledgement of Receipt form (LIC 9224) was provided.

Notice of Site Visit issued and must be posted for 30 days.


SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Patricia Berry
LICENSING EVALUATOR SIGNATURE:

DATE: 01/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3
Citations on this Visit Report are Under Appeal!

Control Number 09-CC-20231214111857
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: 01/23/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Under Appeal
Type A
01/24/2024
Section Cited
CCR
101223(a)(3)
1
2
3
4
5
6
7
Personal Rights (a) The licensee shall ensure that each child is accorded the following personal rights: (3) To be free from corporal or unusual punishment, infliction of pain, ...

This requirement was not met as evidenced by
1
2
3
4
5
6
7
Director stated she will conduct professional development training on personal rights 101223 (a) (3). Director stated she will send the topic of the training and a list of participants to CCL by 1/24/2024.
Director stated she would be interested in the Technical Support Program (TSP).
8
9
10
11
12
13
14
 Based on LPA’s video review of the incident and interviews conducted, staff roughly handled child in care.

This is an immediate risk to the Health, Safety and personal rights of children 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: Gilbert Sena
LICENSING EVALUATOR NAME: Patricia Berry
LICENSING EVALUATOR SIGNATURE:

DATE: 01/23/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3