300613936-9-5-2019-06-CC-MMAK-BFQLW4-20190905090630

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 300613936
Report Date: 09/05/2019
Date Signed: 09/05/2019 09:06:35 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME:	MISSION VIEJO CHRISTIAN KIDS CLUB		FACILITY NUMBER:	300613936
ADMINISTRATOR:	SWEETSER, JOHN		FACILITY TYPE:	840
ADDRESS:	27192 JERONIMO ROAD		TELEPHONE:	(949) 465-1954
CITY:	MISSION VIEJO	STATE: CA	ZIP CODE:	92692
CAPACITY:	175	CENSUS: 8	DATE:	09/05/2019
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME BEGAN:	07:45 AM
MET WITH:	Director		TIME COMPLETED:	09:30 AM

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	Licensing Program Analyst (LPA) Mahnaz (Nancy) Malek conducted a follow-up Case Management Inspection to address the Injury/Unusual Incident report submitted to the Regional Office on 07/24/19. According to the Licensee an Irvine Police Officer disclosed the police department had an open investigation with regards to inappropriate behavior by Staff #1 towards Child #1. Staff #1 was arrested by Irvine Police Department; subsequently Licensee terminated Staff #1. LPA met with Executive Pastor, Brian Eaves. The director, John Sweetser arrived later. There were 8 children with 2 staff whom were transported to be dropped off at elementary school. A review of Staff records on this date indicated that all facility Staff or other individuals who required caregiver background checks have received criminal record and Child abuse index clearances or exemptions. The Investigation Bureau conducted the investigation and Investigator, Ernestina Bellucco interviewed staff, day care children and obtained police report. Investigator interviewed (6) Staff members whom had no knowledge of the inappropriate behavior of Staff #1. Investigator interviewed (5) day-care children whom made no disclosures. The Irvine Police Department’s reports indicate Child #1 disclosed that Staff #1 had Child #1 perform inappropriate touching to Staff #1. The report reveals Staff #1 admitted to the inappropriately touching with Child #1 and disclosed there was a second victim, Child #2. The report indicates Child #2 did not disclose any inappropriate touching to or from Staff #1. Based on Child #1’s disclosure and Staff’s #1 admission, the facility is being cited under California Code of Regulations, Title 22, Division 12, on the attached LIC 809D for the deficiency section 101223(a)(1) under personal rights. An Immediate Civil Penalty is being assessed today in the amount of $500. Civil Penalty determination is pending. Notice of Site Visit was posted. The notice of site visit must be posted for 30 consecutive days. Failure to post will result in civil penalties of $100. The licensee was provided a copy of their appeal right (LIC 9058) and their signature on this form acknowledges receipt of these rights. First level appeal is to Regional Manager; address is above on the report. Upon receipt, licensee shall post and provide copies of this report to parents/Guardians of Children in care and to parents/guardians of Children newly enrolled at the facility during the next 12 months. Licensee may use LIC 9224. A copy of acknowledgement form signed by the Child's representative shall be kept on each Child's file. Exit interview was conducted.

SUPERVISOR'S NAME: Patricia Magana	TELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Mahnaz Malek	TELEPHONE: (714) 292-9851
LICENSING EVALUATOR SIGNATURE:	DATE: 09/05/2019

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/05/2019

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: MISSION VIEJO CHRISTIAN KIDS CLUB	FACILITY NUMBER: 300613936
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/05/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 09/05/2019 Section Cited	1 2 3 4 5 6 7	101223 (a)(1) Personal Rights: (a)The licensee shall ensure that each child is accorded the following personal rights: (1) To be accorded dignity in his/her personal relationships with staff and other persons. This requirement is not met as evidenced by: One child disclosing to parent and police of
	8 9 10 11 12 13 14	Staff #1 being inappropriate while on field trip. Staff #1 admitted to the police of inappropriately touching two children while in care. The licensee failed to meet this section of the regulations. This poses an immediate risk to personal rights of children in care. A $500.00 Civil Penalty is being issued today.Civil Penalty determination is pending.	8 9 10 11 12 13 14	of children. The plan of correction is due by 9/5/2019 to our office. Also provided was information about the E-Learning Modules available at https://ccld.childcarevideos.org including informational video regarding personal rights of children to share with staff.
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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.

SUPERVISOR'S NAME: Patricia Magana	TELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Mahnaz Malek	TELEPHONE: (714) 292-9851
LICENSING EVALUATOR SIGNATURE:	DATE: 09/05/2019

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/05/2019

LIC809 (FAS) - (06/04)

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