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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 376700122
Report Date: 09/01/2021
Date Signed: 09/23/2021 10:01:07 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 STREET, STE 700
RIVERSIDE, CA 92501
This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/24/2021 and conducted by Evaluator Alaina Wilburn
PUBLIC
COMPLAINT CONTROL NUMBER: 10-CC-20210824160520
FACILITY NAME:CHILDREN'S PARADISE-SHADOWRIDGEFACILITY NUMBER:
376700122
ADMINISTRATOR:CHRISTINA JENKINSFACILITY TYPE:
850
ADDRESS:145 N, MELROSE DR. STE 100TELEPHONE:
(760) 724-5600
CITY:VISTASTATE: CAZIP CODE:
92083
CAPACITY:126CENSUS: 77DATE:
09/01/2021
UNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Christina JenkinsTIME COMPLETED:
05:15 PM
ALLEGATION(S):
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Staff are not following COVID-19 protocol.
INVESTIGATION FINDINGS:
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This is an amended report, delivered to the facility on 09/23/2021. Licensing Program Analysts (LPAs) Alaina Wilburn and Susan Brewer conducted an unannounced complaint visit. LPAs met with Assistant Director Leanne Sparks, to discuss the above-mentioned allegation. Later in visit, Director Christina Jenkins arrived to assist with visit.
Investigation consisted of: observation of children in Room #2, #3, #4, #5 #6, #7, Toddler Option (TO1) and Toddler Option (TO2).

Investigation revealed the following: On September 1, 2021, LPAs observed preschool children during drop off and attendance, from approximately 6:30AM to 11:00AM, where preschool children over 2 years of age were present and not wearing a protective face mask in accordance with the Department of Public Health guidelines. There were 46 children present in total not wearing face coverings. In Room #6 with 11 children; Room #5 with 3 children; Room #4 with 8 children; Room #3 with 1 child: Room #2 with 13 children; Toddler Room #1 with 6 children and Toddler Room #2 with 4 children, which poses a potential risk to the health and safety of the children in care.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Stephanie Hudak
LICENSING EVALUATOR NAME: Alaina Wilburn
LICENSING EVALUATOR SIGNATURE:

DATE: 09/01/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/01/2021
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 10-CC-20210824160520
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 STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: CHILDREN'S PARADISE-SHADOWRIDGE
FACILITY NUMBER: 376700122
VISIT DATE: 09/01/2021
NARRATIVE
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On September 1, 2021, Licensee did not ensure the personal rights of persons in care, to safe and healthful accommodations, in that children (C1-C46, see Confidential Names List, LIC 811), were observed not wearing face coverings or not encouraged to wear face coverings, as required by the CA Department of Public Health Guidance on the Use of Face Coverings issued on July 28, 2021, and an individual mask exception did not apply.

Based on LPAs observations, the preponderance of evidence standard has been met, therefore the above allegation staff are not following COVID-19 mandates is found to be SUBSTANTIATED. This poses a potential risk to the health and safety of the children in care. See LIC9099D for cited deficiency. Exit interview conducted.

Appeal rights discussed and a copy of this report was discussed and provided to the Director Christina Jenkins on this date.

A NOTICE OF SITE VISIT WAS ISSUED AND LPA VERIFIED THAT IT WAS POSTED IN A PROMINENT LOCATION AT THE FACILITY BEFORE LEAVING. THE LICENSEE UNDERSTANDS THAT IT MUST REMAIN POSTED FOR THE NEXT 30 DAYS.
SUPERVISORS NAME: Stephanie Hudak
LICENSING EVALUATOR NAME: Alaina Wilburn
LICENSING EVALUATOR SIGNATURE:

DATE: 09/01/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/01/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 10-CC-20210824160520
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 STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: CHILDREN'S PARADISE-SHADOWRIDGE
FACILITY NUMBER: 376700122
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/01/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type B
09/02/2021
Section Cited
CCR
101223(a)(2)
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Personal Rights (a) The Licensee shall ensure that each child is accorded the following personal rights: (2) To be accorded safe, healthful, and comfortable accommodations, furnishings and equipment to meet his/her needs.

This requirement is not met as evidenced by:
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Facility will be sending out a new letter to all staff and parents advising that all staff and children over the age of 2 years old will wear a protective face covering. Staff will sign off on the letter, and a copy will be maintained in their files. Director will send a copy of the revised letter to LPA by 5:00pm, Sept. 2, 2021.
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On September 1, 2021, licensee did not ensure the personal rights of persons in care to safe and healthful accommodations, in that 46 children, C1-C46, were observed not wearing face coverings or not encouraged to wear face coverings, as required by the CA Dept. of Public Health Guidance on the Use of Face Coverings issued on July 28, 2021, and an individual mask exception did not apply, which is a potential health & safety risk to children in care.
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Director will ensure the LIC 9224s (Acknowledgement of Receipt of Licensing Report) are completed within 24 hours for all enrolled children, and future enrollees will be informed of Type B deficiency and the form will be completed. Forms for both enrolled and future enrollees will be maintained on record according to Assembly Bill 633.
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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: Stephanie Hudak
LICENSING EVALUATOR NAME: Alaina Wilburn
LICENSING EVALUATOR SIGNATURE:

DATE: 09/01/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/01/2021
LIC9099 (FAS) - (06/04)
Page: 3 of 3