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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304311628
Report Date: 04/30/2020
Date Signed: 04/30/2020 02:32:35 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
02/21/2020 and conducted by Evaluator Gigi Mai
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20200221101341
FACILITY NAME:MILLEA, JOYFACILITY NUMBER:
304311628
ADMINISTRATOR:MILLEA, JOYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(714) 330-1628
CITY:HUNTINGTON BEACHSTATE: CAZIP CODE:
92646
CAPACITY:14CENSUS: 6DATE:
04/30/2020
UNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Joy Millea - LicenseeTIME COMPLETED:
02:45 PM
ALLEGATION(S):
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Licensee did not report the incident to licensing office.
INVESTIGATION FINDINGS:
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COVID-19 Tele-Inspection

Licensing Program Analyst (LPA) Gigi Mai conducted an unannounced inspection to the facility in response to a complaint received on 2/21/2020 regarding the above allegation. This is a continuation of the investigation initiated on 2/27/2020. During the inspection there was 3 infants and 3 preschool age child with the licensee and no assistant. 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.

During the investigation LPA conducted interviews with the licensee, 2 assistants, 6 parents, 1 child and reviewed photographs of the injury.

(Continued on Page 2 - LIC 9099C)
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Gigi MaiTELEPHONE: (714) 743-8565
LICENSING EVALUATOR SIGNATURE:

DATE: 04/30/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2020
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-20200221101341
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: MILLEA, JOY
FACILITY NUMBER: 304311628
VISIT DATE: 04/30/2020
NARRATIVE
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The complainant stated a child sustained an injury while in care that required medical attention. The licensee stated the parent had picked up child and left the day care. The licensee stated she was not aware she must report the incident to the licensing office. The parent stated she took the child to the urgent care doctor where the child was given first aid cleaning. The photographs reviewed depict a laceration to the right arm. The two assistants interviewed stated they were not present or did not witness the incident when it occurred.

Based on interviews which were conducted, the licensee failed to report the incident which required medical attention. This requirement was not met as evidenced by licensee's disclosure of not reporting the incident and the parent interview where it was confirmed the child received medical attention. Therefore, the preponderance of evidence standard has been met, the allegation: Facility failed to report injury is found to be substantiated. California Code of Regulations, Title 22 Division 12, Article 6, Section 102416.2(b)(1) is being cited on the attached LIC 9099D.

Reporting Requirements 102416.2 (b) The licensee shall report to the Department any of the events as specified in Health and Safety Code Sections 1597.467(b)(1)(A) through (b)(1)(C) that occur during the operation of the family child care home. (1) Medical treatment means treatment by a medical professional, as defined in Section 101152(m).

Exit interview was conducted. Licensee was provided a copy of their appeal rights (LIC 9058 01/16) and their signature on this form acknowledges receipt of these rights. First level appeals should be sent to the regional manager to the address listed above.
SUPERVISOR'S NAME: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Gigi MaiTELEPHONE: (714) 743-8565
LICENSING EVALUATOR SIGNATURE:

DATE: 04/30/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2020
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 06-CC-20200221101341
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: MILLEA, JOY
FACILITY NUMBER: 304311628
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/30/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/01/2020
Section Cited
CCR
102416.2(b)(1)
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102416.2(b)(1) Reporting Requirements (b) The licensee shall report to the Department any of the events...that occur during the operation of the family child care home. (1) Medical treatment means treatment by a medical professional... This requirement was not met as evidenced by:
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The licensee stated she will submit form LIC624B Unusual Incident Report (UIR) to CCLD by due date of 05/01/2020 by mail or Fax 714-703-2831. Licensee agreed to report any future UIR to CCLD within next business day and to submit written report within 7 calendar days.
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Based on interviews and medical documents reviewed. The licensee stated she was not aware she must report the incident to the licensing office. This poses a potential safety risk to 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: Gigi MaiTELEPHONE: (714) 743-8565
LICENSING EVALUATOR SIGNATURE:

DATE: 04/30/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2020
LIC9099 (FAS) - (06/04)
Page: 3 of 5
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
02/21/2020 and conducted by Evaluator Gigi Mai
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20200221101341

FACILITY NAME:MILLEA, JOYFACILITY NUMBER:
304311628
ADMINISTRATOR:MILLEA, JOYFACILITY TYPE:
810
ADDRESS:18902 CAROLYN LANETELEPHONE:
(714) 330-1628
CITY:HUNTINGTON BEACHSTATE: CAZIP CODE:
92646
CAPACITY:14CENSUS: 6DATE:
04/30/2020
UNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Joy Millea - LicenseeTIME COMPLETED:
02:45 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Child sustained an injury while in care.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
COVID-19 Tele-Inspection

Licensing Program Analyst (LPA) Gigi Mai conducted an unannounced inspection to the facility in response to a complaint received on 2/21/2020 regarding the above allegation. This is a continuation of the investigation initiated on 2/27/2020. During the inspection there was 3 infants and 3 preschool age child with the licensee and no assistant. 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.

During the investigation LPA conducted interviews with the licensee, 2 assistants, 6 parents, 1 child and reviewed photographs of the injury.

(Continued on Page 2 - LIC 9099C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Gigi MaiTELEPHONE: (714) 743-8565
LICENSING EVALUATOR SIGNATURE:

DATE: 04/30/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2020
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 06-CC-20200221101341
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: MILLEA, JOY
FACILITY NUMBER: 304311628
VISIT DATE: 04/30/2020
NARRATIVE
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The complainant stated a child sustained an injury while in care. The licensee stated it was end of the day, the parent had picked up child and left the day care. The child left the facility with the parent and walked up to a dog tethered to a tree in the front yard away from the walkway/driveway. This area is not used for daycare. The parent and child walked down the driveway to the grass area to pet the dog and child was bit. The parent stated they took the child to the urgent care doctor where the child was given first aid cleaning. The photographs reviewed depict a laceration to the right arm. The child was given antibiotics at a later follow up doctor visit.

The two assistants interviewed; Assistant #1 stated they were not present when the incident occurred. Assistant #2 stated they were present; however, they were with the children in the backyard and did not witness the incident. LPA interviewed 6 parents. However, due to children’s age or not being available only 1 child was interviewed. This child did not add any pertinent information to the investigation. Interviews conducted with 6 parents disclosed the dog was always tied up and in an off-limit area that is inaccessible to children in care during operating hours.

Based on the information gather from the interviews conducted and photographs reviewed, the child did receive medical attention due to a dog bite, however, there is insufficient evidence to corroborate that the injury occurred while the child was still in the care of the provider. The parent had picked up the child and was leaving when the child left the walkway/driveway and approached the dog. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged supervision violation did or did not occur, therefore the allegation: Child was injured while in care is unsubstantiated.

Exit interview was conducted.
SUPERVISOR'S NAME: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Gigi MaiTELEPHONE: (714) 743-8565
LICENSING EVALUATOR SIGNATURE:

DATE: 04/30/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2020
LIC9099 (FAS) - (06/04)
Page: 5 of 5