Quarterly 710 Report

Reporting reporting period:01/01/2022 – 03/31/2022      
Agency Name:Cornerstone Valley, Inc.      
Total Number of Children in Care:24      
        
Setting AddressDouglasJuniperMaplePonderosaSequoiaWillowCypress
A.) Number of Children in Care in this setting during this reporting period3432543
B.) Total # of Incidents involving restraint07035202
C.) Total # of incidents resulting in a reportable injury arising from the use of a restraint.0000000
D.) Total # of children who were placed in restraint more than three times0001000
E.) Total # of incidents in which a person who placed a child in care in a restraint was not certified in the use of the type of restraint used0000000
F.) Total # of incidents involving involuntary seclusion0000000
G.) Total # of Incidents involving involuntary seclusion in a locked room0000000
H.) Number of rooms that have been used or would be used for involuntary seclusion0000000
I.) Dimensions of room that has been used or could be used for involuntary seclusionN/AN/AN/AN/AN/AN/AN/A
J.) Total # of children who were placed in involuntary seclusion more than three times0000000
K.) Total # of incidents in which a person who placed a child in care in involuntary seclusion was not trained to use involuntary seclusion0000000

Quarterly 710 Report

 

Agency Name 

Cornerstone Valley, Inc.

Site or Program Name 

*Each location serves four or fewer children. Therefore, only one report is required to be completed for the entire program. 

Reporting time frame (indicate which quarter and year). 

Q4, 2021 

Total number of incidents involving restraint. 

36

Total number of incidents involving involuntary seclusion. 

0

The total number of incidents involving restraint and seclusion that resulted in reportable injuries. 

0



Total number of involuntary seclusions in a locked room. 

0

Total number of rooms available for use for involuntary seclusion. 

0

Description of the dimensions and design of the seclusion rooms. 

N/A

Total number of children in care placed in restraint. 

5

Total number of children in care placed in involuntary seclusion: 

0

Total number of children in care who were placed in restraint or involuntary seclusion more than three times during the reporting period. 

4

A description of the steps the program has taken to decrease the use of restraint and involuntary seclusion. 

Re-trainings on implementation of proactive strategies described in each Positive Behavior Support Plan (PBSP).

Number of incidents in which an individual who placed a child in care in a restraint or involuntary seclusion was not certified or trained in the use of the type of restraint or involuntary seclusion used, including individuals whose certification or training was expired at the time of the restraint or seclusion. 

0

 

Demographic characteristics of the children in care who the program placed in a restraint or involuntary seclusion, including race, ethnicity, gender, disability status, migrant status, English proficiency and status as economically disadvantaged, unless the demographic information would reveal personally identifiable information about an individual child in care. Indicate the number of children who experienced restraint or seclusion who match each of the criteria listed below: 

 

Race/Ethnicity

American Indian or Alaska Native 0

Asian 1

Black or African American 0 

Native Hawaiian 0

Other Pacific Islander 0

White 4

 

Gender

Male 3 

Female 2

Transgender 0

Non-binary 0

 

Disability Status

Disabled 5

Non-Disabled 0 

 

Migrant Status

Non-Migrant 5

Migrant 0

 

English Proficiency

English is primary language 4

English is not primary language 1

 

Economic Status

Economically Disadvantaged 0

Not Economically Disadvantaged 5