RUSD/LONGFELLOW ELEMENTARY SCHOOL

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25On 11/14/2024 at 9:15 AM, Licensing Program Analyst (LPA) Tiffanie Diep met with Teacher (S1) Guny Arroyo for the purpose of an unannounced case management inspection to follow up on an Unusual Incident Report (UIR) submitted to the Department on 10/31/2024. The incident was reported by the facility within the required timeframe. LPA observed five staff supervising 31 children. All individuals subject to a criminal record review have obtained a criminal record clearance. S1 was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of five days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated. Continues on LIC 809-C SUPERVISORS NAME: Ana Noble LICENSING EVALUATOR NAME: Tiffanie Diep LICENSING EVALUATOR SIGNATURE: DATE: 11/14/2024 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/14/2024 This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC809 (FAS) - (06/04)Page: 1 of 2 FACILITY NAME: RUSD/LONGFELLOW ELEMENTARY SCHOOLFACILITY NUMBER: 334802359 VISIT DATE: 11/14/2024 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 32Continued from LIC 809 (Page 2) Since the previous visit, LPA obtained supporting documentation pertinent to the incident and conducted interviews with pertinent individuals involved in the incident. It was alleged that a child (C1) was touched inappropriately on one occasion. Conflicting information was obtained regarding the alleged individual and where the incident took place. Interviews conducted disclosed staff have observed C1 with concerning behavior since their enrollment. It was disclosed staff did not observe any changes in C1’s behavior prior to and after the incident. Information obtained revealed staff have been actively working with C1 and their family to implement social emotional support strategies. Records reviewed indicated staff contacted all relevant parties in a timely manner and C1 has returned to the facility since the incident. It is determined there was a lack of clear corroborating evidence to prove the alleged incident did or did not occur. Based on information obtained during interviews and records reviewed, it is determined there were no violations pertaining to the incident. There were no deficiencies cited at this time. An exit interview was conducted and report was reviewed with the teacher, Guny Arroyo. A notice of site visit was given and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. SUPERVISORS NAME: Ana Noble LICENSING EVALUATOR NAME: Tiffanie Diep LICENSING EVALUATOR SIGNATURE: DATE: 11/14/2024 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/14/2024

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25On 11/14/2024 at 9:15 AM, Licensing Program Analyst (LPA) Tiffanie Diep met with Teacher (S1) Guny Arroyo for the purpose of an unannounced case management inspection to follow up on an Unusual Incident Report (UIR) submitted to the Department on 10/31/2024. The incident was reported by the facility within the required timeframe. LPA observed five staff supervising 31 children. All individuals subject to a criminal record review have obtained a criminal record clearance. S1 was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of five days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated. Continues on LIC 809-C SUPERVISORS NAME: Ana Noble LICENSING EVALUATOR NAME: Tiffanie Diep LICENSING EVALUATOR SIGNATURE: DATE: 11/14/2024 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/14/2024 This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC809 (FAS) - (06/04)Page: 1 of 2 FACILITY NAME: RUSD/LONGFELLOW ELEMENTARY SCHOOLFACILITY NUMBER: 334802359 VISIT DATE: 11/14/2024 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 32Continued from LIC 809 (Page 2) Since the previous visit, LPA obtained supporting documentation pertinent to the incident and conducted interviews with pertinent individuals involved in the incident. It was alleged that a child (C1) was touched inappropriately on one occasion. Conflicting information was obtained regarding the alleged individual and where the incident took place. Interviews conducted disclosed staff have observed C1 with concerning behavior since their enrollment. It was disclosed staff did not observe any changes in C1’s behavior prior to and after the incident. Information obtained revealed staff have been actively working with C1 and their family to implement social emotional support strategies. Records reviewed indicated staff contacted all relevant parties in a timely manner and C1 has returned to the facility since the incident. It is determined there was a lack of clear corroborating evidence to prove the alleged incident did or did not occur. Based on information obtained during interviews and records reviewed, it is determined there were no violations pertaining to the incident. There were no deficiencies cited at this time. An exit interview was conducted and report was reviewed with the teacher, Guny Arroyo. A notice of site visit was given and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. SUPERVISORS NAME: Ana Noble LICENSING EVALUATOR NAME: Tiffanie Diep LICENSING EVALUATOR SIGNATURE: DATE: 11/14/2024 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/14/2024

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25On 11/14/2024 at 9:15 AM, Licensing Program Analyst (LPA) Tiffanie Diep met with Teacher (S1) Guny Arroyo for the purpose of an unannounced case management inspection to follow up on an Unusual Incident Report (UIR) submitted to the Department on 10/31/2024. The incident was reported by the facility within the required timeframe. LPA observed five staff supervising 31 children. All individuals subject to a criminal record review have obtained a criminal record clearance. S1 was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of five days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated. Continues on LIC 809-C SUPERVISORS NAME: Ana Noble LICENSING EVALUATOR NAME: Tiffanie Diep LICENSING EVALUATOR SIGNATURE: DATE: 11/14/2024 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/14/2024 This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC809 (FAS) - (06/04)Page: 1 of 2 FACILITY NAME: RUSD/LONGFELLOW ELEMENTARY SCHOOLFACILITY NUMBER: 334802359 VISIT DATE: 11/14/2024 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 32Continued from LIC 809 (Page 2) Since the previous visit, LPA obtained supporting documentation pertinent to the incident and conducted interviews with pertinent individuals involved in the incident. It was alleged that a child (C1) was touched inappropriately on one occasion. Conflicting information was obtained regarding the alleged individual and where the incident took place. Interviews conducted disclosed staff have observed C1 with concerning behavior since their enrollment. It was disclosed staff did not observe any changes in C1’s behavior prior to and after the incident. Information obtained revealed staff have been actively working with C1 and their family to implement social emotional support strategies. Records reviewed indicated staff contacted all relevant parties in a timely manner and C1 has returned to the facility since the incident. It is determined there was a lack of clear corroborating evidence to prove the alleged incident did or did not occur. Based on information obtained during interviews and records reviewed, it is determined there were no violations pertaining to the incident. There were no deficiencies cited at this time. An exit interview was conducted and report was reviewed with the teacher, Guny Arroyo. A notice of site visit was given and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. SUPERVISORS NAME: Ana Noble LICENSING EVALUATOR NAME: Tiffanie Diep LICENSING EVALUATOR SIGNATURE: DATE: 11/14/2024 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/14/2024

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25On 11/14/2024 at 9:15 AM, Licensing Program Analyst (LPA) Tiffanie Diep met with Teacher (S1) Guny Arroyo for the purpose of an unannounced case management inspection to follow up on an Unusual Incident Report (UIR) submitted to the Department on 10/31/2024. The incident was reported by the facility within the required timeframe. LPA observed five staff supervising 31 children. All individuals subject to a criminal record review have obtained a criminal record clearance. S1 was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of five days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated. Continues on LIC 809-C SUPERVISORS NAME: Ana Noble LICENSING EVALUATOR NAME: Tiffanie Diep LICENSING EVALUATOR SIGNATURE: DATE: 11/14/2024 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/14/2024 This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC809 (FAS) - (06/04)Page: 1 of 2 FACILITY NAME: RUSD/LONGFELLOW ELEMENTARY SCHOOLFACILITY NUMBER: 334802359 VISIT DATE: 11/14/2024 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 32Continued from LIC 809 (Page 2) Since the previous visit, LPA obtained supporting documentation pertinent to the incident and conducted interviews with pertinent individuals involved in the incident. It was alleged that a child (C1) was touched inappropriately on one occasion. Conflicting information was obtained regarding the alleged individual and where the incident took place. Interviews conducted disclosed staff have observed C1 with concerning behavior since their enrollment. It was disclosed staff did not observe any changes in C1’s behavior prior to and after the incident. Information obtained revealed staff have been actively working with C1 and their family to implement social emotional support strategies. Records reviewed indicated staff contacted all relevant parties in a timely manner and C1 has returned to the facility since the incident. It is determined there was a lack of clear corroborating evidence to prove the alleged incident did or did not occur. Based on information obtained during interviews and records reviewed, it is determined there were no violations pertaining to the incident. There were no deficiencies cited at this time. An exit interview was conducted and report was reviewed with the teacher, Guny Arroyo. A notice of site visit was given and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. SUPERVISORS NAME: Ana Noble LICENSING EVALUATOR NAME: Tiffanie Diep LICENSING EVALUATOR SIGNATURE: DATE: 11/14/2024 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/14/2024

Type B citation - potential risk if not corrected

Type B citation - potential risk if not corrected