304310300-6-28-2019-06-CC-RLOZ-BENNUB-20190802104603

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 304310300
Report Date: 06/28/2019
Date Signed: 06/28/2019 10:13:06 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

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

This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/29/2019 and conducted by Evaluator Thuy Ho

PUBLIC

COMPLAINT CONTROL NUMBER: 06-CC-20190529145122

FACILITY NAME:	TRAN, THAO		FACILITY NUMBER:	304310300
ADMINISTRATOR:	TRAN, THAO		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(714) 839-6773
CITY:	GARDEN GROVE	STATE: CA	ZIP CODE:	92843
CAPACITY:	14	CENSUS: 3	DATE:	06/28/2019
		UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Licensee Thao Tran		TIME COMPLETED:	10:30 AM

ALLEGATION(S):

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Day Care staff yelled at daycare child.
Day Care staff hit daycare child.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Ho conducted an unannounced inspection on this date. This is a continuation of the investigation that was initiated on 6/7/2019. Upon arrival, LPA met with licensee. A review of staff criminal clearance records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

LPA observed 3 children with 3 staff members. During today's inspection it was determined that the facility was operating within its licensed capacity and within compliance of staffing ratios.

During the course of the investigation, LPA reviewed the children's records, interviewed 3 staff members, three children, and two parents.

The complainant reported that a staff member hit and yelled at a day care child. The licensee and staff interviewed denied the allegations. Interviewed children and parent did not disclose any information

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Thuy Ho	TELEPHONE: (714) 703-2824
LICENSING EVALUATOR SIGNATURE:	DATE: 06/28/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2019

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

LIC9099 (FAS) - (06/04)

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Control Number 06-CC-20190529145122

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: TRAN, THAO	FACILITY NUMBER: 304310300
	VISIT DATE: 06/28/2019

NARRATIVE

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that support the allegations. Based on these gathered information, there is insufficient evidence to determine a personal rights violations occurred.

Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations of personal rights did or did not occur, therefore the allegations are unsubstantiated.

Exit interview was conducted. Notice of Site Visit was posted during the visit. Facility representative was informed that the notice of site visit must be posted for 30 consecutive days. Failure to post will result in civil penalties of $100.

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Thuy Ho	TELEPHONE: (714) 703-2824
LICENSING EVALUATOR SIGNATURE:	DATE: 06/28/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2019

LIC9099 (FAS) - (06/04)

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