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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304310966
Report Date: 09/10/2021
Date Signed: 09/10/2021 03:43:58 PM



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
09/07/2021 and conducted by Evaluator Carmen Odom
COMPLAINT CONTROL NUMBER: 06-CC-20210907100253
FACILITY NAME:OROZCO, HEIDIFACILITY NUMBER:
304310966
ADMINISTRATOR:OROZCO, HEIDIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(949) 764-9143
CITY:COSTA MESASTATE: CAZIP CODE:
92627
CAPACITY:14CENSUS: 9DATE:
09/10/2021
UNANNOUNCEDTIME BEGAN:
09:20 AM
MET WITH:TIME COMPLETED:
03:50 PM
ALLEGATION(S):
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Licensee did not prevent a daycare child from wandering.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Carmen Odom conducted an unannounced complaint investigation on today’s date 9/10/21. LPA met with assistant, Kimberly Orozco, and discussed the purpose of the investigation. Present was 2 assistants and Licensee arrived at 9:40am. Census was taken and there was a total of 7 children present; 3 infants and 6 preschool age children napping and playing in the back outdoor patio.

A review of criminal record clearances indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

Continue to page 2.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Carmen OdomTELEPHONE: (714) 703-2819
LICENSING EVALUATOR SIGNATURE:

DATE: 09/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 5
Control Number 06-CC-20210907100253
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: OROZCO, HEIDI
FACILITY NUMBER: 304310966
VISIT DATE: 09/10/2021
NARRATIVE
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During the investigation LPA interviewed Licensee, 2 assistants, 3 children, took pictures, measured the distance from the family childcare home to location Child #1 (C1) was found and requested copies of children roster LIC9040. It was discovered in the transition of outdoor play to snack after 11:30am C1 was not hungry, and fussy. Staff#1 (S1) took C1 into the childcare bedroom for nap time, placed C1 in playpen, S1 left the room and C1 got out of the playpen and S1 took C1 into the bedroom and placed C1 in playpen for a second time. S1 returned to the kitchen to assist Staff#2 (S2) and Staff#3(S3) in feeding the children inside the kitchen, bedroom hallway and front door not visible from the kitchen. Around 11:50am S1 went to the bedroom to check on C1, and C1 was not in the playpen, bedroom or nowhere to be found inside and outside the home. At around 11:55am S1 went out in the front of the home to search for C1 on the street and neighbors’ home. At 12:00pm S1 got in the vehicle to search for C1 around the block. As 12:06pm S1 called 911 Costa Mesa PD and C1’s parents. CMPD arrived less than 5 minutes later and informed S1 that C1 was found 1 ½ blocks away from the childcare. Based on interviews, C1 eloped for about a total of 15 minutes on their own, C1 got out of the playpen, through the hallway, unlocked the front door, opened the door, walked down the driveway, and walked for 11 minutes approximately 820 feet adult walking steps from the childcare. C1 returned to the childcare on 9/7/21. Licensee stated, a baby door has been placed in the front entrance, a door lock latch was placed at the top of the door, and an alarm system was purchased. Regarding the reported incident, the staff failed to visually observe the child in care. Throughout the course of the investigation in an interview, S1 stated, unusual incident report was not called within 24 hours or LIC624 form was not sent to licensing office.

Based on LPA’s facility inspection, observations, interviews conducted with licensee, 2 assistants and 3 children, CPS report and pictures taken by LPA, it has been determined that Licensee did not prevent a daycare child from wandering off the premises. Therefore, the preponderance of evidence standard has been met, therefore the above allegation is found to be Substantiated.

In the areas that were evaluated, the facility was not in compliance of the California Code of Regulations, Title 22, Division 12. The following citation under Operation of a Family Childcare Home section 102417(a) and Reporting Requirements section 102416.2(b) was issued today on the attached LIC 809D. An immediate civil penalty of 500.00 was assessed today.
Continue to page 3.
SUPERVISOR'S NAME: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Carmen OdomTELEPHONE: (714) 703-2819
LICENSING EVALUATOR SIGNATURE:

DATE: 09/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 06-CC-20210907100253
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: OROZCO, HEIDI
FACILITY NUMBER: 304310966
VISIT DATE: 09/10/2021
NARRATIVE
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Page 3

Upon receiving Type A violation, the Licensee shall post and provide copies of the report to parents/guardians of the children in care at the facility by the next business day, and shall provide to the parents/guardians of children newly enrolled at the facility during the next 12 months. The director is to keep Acknowledgement Receipt (LIC 9224) signed by parents in each child’s file.

The Notice of Site Visit was posted. 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. The interim director was provided a copy of their appeal right (LIC 9058 01/16) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Licensing office within 15 business days.
SUPERVISOR'S NAME: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Carmen OdomTELEPHONE: (714) 703-2819
LICENSING EVALUATOR SIGNATURE:

DATE: 09/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2021
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 06-CC-20210907100253
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: OROZCO, HEIDI
FACILITY NUMBER: 304310966
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/10/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/10/2021
Section Cited
CCR
102417(a)
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102417(a) Operation of a Family Childcare Home (a) The licensee shall be present in the home and shall ensure that children in care are supervised at all times. When circumstances require the licensee to be temporarily absent from the home, the licensee shall arrange for a substitute... This requirement is not met as evidenced by:
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Licensee already enforce security measures by installing baby door at the entrance, door lock latch on entrance door, doornobs and purchased alarm systen for the childcare facility. Licensee will provide a statement on POC by 9/10/21. Informal meeting will be scheduled with reginal manager.
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Based on interviews, Licensee and staff#1 failed to visually observe C1 there was absence of supervision for about 15 mintues. C1 was found by bystanders 820 feet away from the childcare facility. This poses an immediate Health and Safety risk to the children in care.
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Civil Penalties has been assessed for $500.
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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: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Carmen OdomTELEPHONE: (714) 703-2819
LICENSING EVALUATOR SIGNATURE:

DATE: 09/10/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2021
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 06-CC-20210907100253
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: OROZCO, HEIDI
FACILITY NUMBER: 304310966
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/10/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/10/2021
Section Cited
CCR
102416.2(b)
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102416.2(b) Reporting Requirements. The licensee shall report to the Department
any of the events as specified in Health and Safety Code Section 1597.467(b)(1)(A)
through (b)(1)(C) that occur during the operation of the family child care home. This requirement is not met as evidenced by:
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A copy of the LIC624 unusual incident report for incident on 9/3/21 will be provided to LPA by 9/13/21.
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Based on observation and interview, Licensee failed to report incident involving C1 eloping the childcare facility. This poses a potential risk to the health and safety of children in care.
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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: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Carmen OdomTELEPHONE: (714) 703-2819
LICENSING EVALUATOR SIGNATURE:

DATE: 09/10/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2021
LIC9099 (FAS) - (06/04)
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