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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 376600729
Report Date: 05/07/2026
Date Signed: 05/07/2026 02:04:51 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/25/2026 and conducted by Evaluator Kelly Gerth
PUBLIC
COMPLAINT CONTROL NUMBER: 10-CC-20260325093837

FACILITY NAME:CHILDTIME CHILDREN'S CENTER-INFANTFACILITY NUMBER:
376600729
ADMINISTRATOR:NIKOLE DUMASFACILITY TYPE:
830
ADDRESS:4280 VIA RANCHO ROADTELEPHONE:
(760) 967-5846
CITY:OCEANSIDESTATE: CAZIP CODE:
92057
CAPACITY:24CENSUS: DATE:
05/07/2026
UNANNOUNCEDTIME BEGAN:
01:50 PM
MET WITH:Director Nikole Dumas TIME COMPLETED:
02:22 PM
ALLEGATION(S):
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Staff did not follow infants individual feeding plan.
INVESTIGATION FINDINGS:
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 On the above date and time, Licensing Program Analyst (LPA) Kelly Gerth arrived at the facility to deliver the findings from a complaint received by Community Care Licensing (CCL) on March 25, 2026. LPA met with Director Nikole Dumas and provided the purpose of the visit. LPA toured the facility and took census. It was alleged that the Staff did not follow infants individual feeding plan.

On March 27, 2026, LPA Gerth initiated the investigation at the CCC. During the visit, LPA Gerth interviewed Staff 1 through Staff 4 (S1–S4), collected documents pertinent to the investigation, and conducted file reviews. On March 26, 2026, LPA Gerth also conducted an interview with the Reporting Party. Interviews with staff corroborated that the infant in care was accidentally served the food item, and staff reported they were not aware of the child’s allergy prior to the incident. However, record and file reviews revealed that the infant had a severe allergy care plan on file, including a physician’s statement and prescribed medication in the event of ingestion. Additionally, the CCC maintained allergy chart postings that included the infant’s allergy information.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Kelly Gerth
LICENSING EVALUATOR SIGNATURE:

DATE: 05/07/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 10-CC-20260325093837
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: CHILDTIME CHILDREN'S CENTER-INFANT
FACILITY NUMBER: 376600729
VISIT DATE: 05/07/2026
NARRATIVE
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 Based on LPA’s observation, interviews conducted and documents gathered, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED.

See 809 D Page for Deficiencies issued.

An exit interview was conducted and a copy of the report along with the appeal rights were provided to Director Nikole Dumas. A Notice if site visit was handed to Director and must remain posted for 30 days.
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Kelly Gerth
LICENSING EVALUATOR SIGNATURE:

DATE: 05/07/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2026
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 10-CC-20260325093837
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: CHILDTIME CHILDREN'S CENTER-INFANT
FACILITY NUMBER: 376600729
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/07/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/21/2026
Section Cited
CCR
101427(c)
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101427(c) Infant Care Food Service (c) The infant shall be fed in accordance with the individual plan. This requirement was not met as evidenced by;
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Facility Representative stated that the CCC will submit to CCL, a copy of the staff meeting agenda and sign in/out, covering a staff training on the regulation cited and the CCC’s updated internal plan of steps taken in the event an infant/child ingests a known food allergy, while in care.
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 Based on observation, interview and record review the licensee did not comply with the section cited above in 1/1 infants were served food that was noted as a diagnosed food allergy on their Infant Feeding Plan, which poses/posed a potential 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: Carlos Martinez
LICENSING EVALUATOR NAME: Kelly Gerth
LICENSING EVALUATOR SIGNATURE:

DATE: 05/07/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2026
LIC9099 (FAS) - (06/04)
Page: 5 of 5