304270683-9-13-2021-06-CC-ECOL-C6TUUP-20210913155352

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304270683
Report Date: 09/13/2021
Date Signed: 09/13/2021 03:53:56 PM

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:	MAOF CHILD CARE CENTER-SANTA ANA		FACILITY NUMBER:	304270683
ADMINISTRATOR:	JOSIE BARTOLO		FACILITY TYPE:	850
ADDRESS:	2033 WEST EDINGER STREET		TELEPHONE:	(714) 557-2686
CITY:	SANTA ANA	STATE: CA	ZIP CODE:	92704
CAPACITY:	50	CENSUS: 8	DATE:	09/13/2021
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME BEGAN:	01:45 PM
MET WITH:	Director Josie Bartado		TIME COMPLETED:	04:15 PM

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	This is a Continuation Case Management - Incident Inspection that was initiated on 09/08/2021. LPA Corral reviewed the COVID-19 Questionnaire with Staff Supervisor, Josie Bartolo. LPA Corral met with Josie Bartolo, there were 8 preschool children present with 5 staff members providing care and supervision. Due to COVID 19 Guidelines, LPA Corral observed staff members wearing face masks, social distancing and following CDC and Dept of Public Health Guidelines. During the inspection it was determined the facility is operating within its licensed capacity and within compliance of staffing ratios. A review of the Facility Personnel Report Summary on 09/09/2021 indicates all facility staff or other individuals who required caregiver background checks have received criminal record and child abuse index clearances or exemptions. Licensing Program Analyst (LPA) Corral conducted a Case Management Inspection on 09/08/2021 to investigate an Unusual Incident Report (UIR) which was self-reported to our office on 08/26/2021. The UIR stated a 4-year-old child (C1) cried and said she was afraid to go to school because S1 hit her on the thigh. LPA Corral returned to the Facility on today's date to conduct interviews with the affected Child and Alleged Teacher involved. During today's inspection, LPA Corral conducted a Staff Interview. During the Interview with Staff 1, S1 stated she was not involved in any incident and said she did not do anything, and wasn't sure why C1 said that. S1 stated, "I have not done anything. I don't know." Staff 1 also informed LPA Corral that since the child returned to care C1 is with her and follows her. Staff 1 stated the Child wants to go with her and asks for help during class activities. LPA Corral was unable to interview the affected child after 2 attempts that were made on 09/08/2021 and 09/13/2021 as Child was not present in care due to unrelated reasons. LPA Corral did call Child's mother on 09/13/2021. Child's Mother stated child is happy in care, Mother said she has no concerns about the school or her Child. Mother stated Child informed her the teachers are nice to her, and Child looks good during drop off and pick up. Overall Mother said Child is doing great in school. Continue to Page 2.

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Eileen Corral	TELEPHONE: (714) 743-8354
LICENSING EVALUATOR SIGNATURE:	DATE: 09/13/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2021

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: MAOF CHILD CARE CENTER-SANTA ANA	FACILITY NUMBER: 304270683
	VISIT DATE: 09/13/2021

NARRATIVE

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The Facility also conducted their own internal investigation with Norma Rivera the Staff Development Supervisor. Staff Supervisor Josie asked the questions and both Josie and Norma took notes as the questions were answered. That process was taken with the Children and Staff Interviews. Josie informed LPA Corral that 9 children from Classroom #2 were interviewed, and 5 children from Classroom #1 were interviewed. Six Staff members were also interviewed regarding the incident. Copies of the Interviews the Facility conducted were provided to LPA Corral. Josie stated that based on the interviews with children and staff the Facility could not concluded that the Alleged Teacher violated the Child's Rights.

Based on the information obtained by LPA Corral interviews with Child’s parent, Director and two Staff Members, a citation is not being issued. LPA Corral conducted an Exit Interview with Staff Supervisor Josie Bartolo. The report was read reviewed and discussed with Josie. Appeal Rights were also explained, a Copy of Appeal Rights were provided and signature on this form acknowledges receipt of these rights. Josie was informed all appeals must be in writing and received by the Regional Office within 15 business days. Notice of Site Visit was provided and posted by Director. Director was informed the Notice of Site Visit must be posted for 30 consecutive days and failure to post will result in a Civil Penalty of $100.00.

End of Report.

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Eileen Corral	TELEPHONE: (714) 743-8354
LICENSING EVALUATOR SIGNATURE:	DATE: 09/13/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2021

LIC809 (FAS) - (06/04)

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