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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 367750048
Report Date: 06/15/2023
Date Signed: 06/15/2023 12:25:51 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/04/2023 and conducted by Evaluator Kendal Zirbes
PUBLIC
COMPLAINT CONTROL NUMBER: 12-CC-20230504162359
FACILITY NAME:SBCSS BIG BEAR STATE PRESCHOOLFACILITY NUMBER:
367750048
ADMINISTRATOR:NANCY ALVARADO/KIM WEBERFACILITY TYPE:
850
ADDRESS:44500 BALDWIN LANETELEPHONE:
(909) 585-7766
CITY:SUGAR LOAF/BIG BEARSTATE: CAZIP CODE:
92386
CAPACITY:23CENSUS: 11DATE:
06/15/2023
UNANNOUNCEDTIME BEGAN:
10:50 AM
MET WITH:Facility Representative Maria GonzalezTIME COMPLETED:
11:45 AM
ALLEGATION(S):
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Staff handled day care child in a rough manner
Staff did not notify day care child's parent of incidents
INVESTIGATION FINDINGS:
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On June 15, 2023, at 10:50 a.m., Licensing Program Analyst (LPA) Kendal Zirbes conducted an unannounced follow-up complaint inspection and met with facility representative Maria Gonzalez. LPA disclosed the purpose of the inspection and was granted entry into the facility. 11 children and two staff were present in the facility during this inspection.
On May 4, 2023, the Department received a complaint alleging that in November 2022 staff 1 (S1) handled child 1 (C1) in a rough matter and grabbed C1’s hands after C1 spit water in the face of S1. Over the course of the investigation, LPA reviewed facility records and conducted confidential interviews with staff, children, and parents. As a result of this incident, witnesses did observe C1 and S1 on the ground. LPA did receive conflicting statements during the interviews, on how C1 and S1 ended up on the ground. The witness stated no marks or bruises were observed on C1. During the investigation, it was also revealed that a second incident occurred in September 2022 when S1 was observed holding C1 by the wrist while walking towards the parking lot of the school as C1 lagged behind S1. Report continued on page two
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:

DATE: 06/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/15/2023
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 12-CC-20230504162359
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: SBCSS BIG BEAR STATE PRESCHOOL
FACILITY NUMBER: 367750048
VISIT DATE: 06/15/2023
NARRATIVE
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Report continued from page one

The witness stated C1’s wrist was a little red, no medical attention was needed. During the LPA file review of the children’s records on May 8, 2023. LPA observed handwritten case notes regarding children’s behaviors. Some children’s records contained Ouch reports. C1s file contained two handwritten notes from 8/8/22 and 9/30/22 regarding C1’s interactions with other classmates and teachers. Confidential interviews reveal parents, or the Department are not notified if the children are not hurt. The above incidents were not reported to C1’s mother or to the department within the required reporting requirement time frame.
Based on confidential interviews and record review, the above allegations are valid because the preponderance of the evidence has been met, therefore, the above allegations are found to be substantiated. California Code of Regulations, Title 22, Division 12, Chapter 1, regulation 101223 (a)(3) Personal Rights and 101212 (f) Reporting Requirements are being cited on the attached LIC 9099D.

A notice of site visit was given and must remain posted for 30 days. An exit interview was conducted, and the report was reviewed with facility representative Maria Gonzalez.
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:

DATE: 06/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/15/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 12-CC-20230504162359
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: SBCSS BIG BEAR STATE PRESCHOOL
FACILITY NUMBER: 367750048
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/15/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/29/2023
Section Cited
CCR
101223(a)(3)
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101223 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…humiliation…mental abuse or other actions of a punitive nature…This requirement was not met as evidenced by:
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Per Facility Representative,
a plan will be submitted to the Department by 6/29/23 regarding how the Center will correct the situation to ensure that this does not happen again.
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Based on interviews and record review, C1 was not free from unusual punishment on more than one occasion between Sept, 2022 and Nov 2022 when S1 handled C1 in a rough manner. C1 did not receive medical attention. This posed a potential personal rights risk to the children in care.
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Type B
06/29/2023
Section Cited
CCR
101212(f)
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101212 Reporting Requirements (f) The items specified in (d)(1)(A) through (H) above shall also be reported to the child's authorized representative. This requirement was not met as evidenced by:
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Per Facility Representative,
a plan will be submitted to the Department by 6/29/23 regarding how the Center will correct the situation to ensure that this does not happen again.
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Based on interviews and record review, the licensee did not ensure that an unusual incident involving C1 in November 2022 was reported to C1 authorized representative. This posed a potential personal rights risk to the children 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: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:

DATE: 06/15/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/15/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3