304312178-2-11-2022-06-CC-RLOZ-CBQSGJ-20220217125202

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 304312178
Report Date: 02/11/2022
Date Signed: 02/11/2022 11:04:03 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
11/15/2021 and conducted by Evaluator Pat Rivas

PUBLIC

COMPLAINT CONTROL NUMBER: 06-CC-20211115104140

FACILITY NAME:	SILVA, HEMAMALI		FACILITY NUMBER:	304312178
ADMINISTRATOR:	SILVA, HEMAMALI		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(949) 400-2268
CITY:	FOOTHILL RANCH	STATE: CA	ZIP CODE:	92610
CAPACITY:	14	CENSUS: 10	DATE:	02/11/2022
		UNANNOUNCED	TIME BEGAN:	10:15 AM
MET WITH:	Hemamali Silva, Licensee		TIME COMPLETED:	11:00 AM

ALLEGATION(S):

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Licensee not following Covid-19 safety protocols.
Licensee is operating over ratio

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Patricia Rivas conducted a complaint visit to render findings for the above allegations. A review of staff records indicates all facility staff or individuals who require caregiver background checks have received a criminal record clearances or exemptions and a child abuse index clearance. A Facility Risk assessment was conducted to determine the level of Personal Protective Equipment (PPE) was needed for an on-site inspection. LPA viewed staff wearing masks. LPA viewed 10 children in care (4 infants).

On 11/15/21 the Regional Office received a complaint alleging; 1) Licensee not following Covid-19 safety protocols and 2) Licensee is operating over ratio.

The investigation consisted of; interview with licensee, and 4 families, review of facility records.
In reference to the allegation that the Licensee is not following Covid-19 safety protocols; Licensee, Silva denied not following protocols. Mrs. Silva reports she enforces mask usage, of adults and children over 2

Cont. on 9099c

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Pat Rivas	TELEPHONE: 714-703-2800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2022

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-20211115104140

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: SILVA, HEMAMALI	FACILITY NUMBER: 304312178
	VISIT DATE: 02/11/2022

NARRATIVE

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years old inside the facility. Ms. Silva also reported that she does a symptom check upon entrance and if children are exhibiting any cold symptoms, she does not allow them to enter facility. Ms. Silva indicated her protocols include, removing shoes upon entering home, washing/sanitizing hands. Cleans home daily, sanitizes toys daily. Ms. Silva also indicated that after a Positive Covid-19 incident she had everyone
quarantine due to level of exposure to everyone. In order to return to daycare she had children and herself had to have a Negative Covid-19 Test . Review of 6 of 6 children files found a COVID-19 update to the Admission Agreement that indicates indicate; “If a Cub Care child or family member becomes infected with covid 19, please inform me immediately. The Cub Care child may not return to daycare for 14 days.(#of Days change with Department of Public Health guidelines) I will allow you to take 1 week of unpaid sick leave; however, you will be liable for the payment of 1 week. A negative PCR test must be presented upon return to the daycare (for the sick child or family member)”. Interview with 4 of 7 parents contacted indicated Ms. Silva follows COVID-19 Protocols, wears mask, postings are on front door, hands are sanitized upon entrance and they did sign Update to Admission Agreement for COVID-19. LPA was unable to interview 3 of 7 parents, calls were not returned. Upon entrance LPA Rivas observed postings for masking, hygiene, social distancing, visitation policies on front door. LPA could not corroborate allegation.

In reference to the allegation that the Licensee is operating out of ratio; Ms. Silva indicates she never has over 12 or 14 children with an assistant. Ms. Silva indicates she had a few part time children attend day care. Review of sign in records did not show Ms. Silva had over her licensed capacity. Interview with 4 of 7 parents indicate they had not observed more than 5-6 children in care. LPA was unable to interview 2 of 7 parents, calls were not returned. On 11/17/21 Licensee was only caring for 8 children (no infants) with an assistant present. LPA could not corroborate allegation.

Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegations are unsubstantiated.

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Pat Rivas	TELEPHONE: 714-703-2800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2022

LIC9099 (FAS) - (06/04)

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Control Number 06-CC-20211115104140

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: SILVA, HEMAMALI	FACILITY NUMBER: 304312178
	VISIT DATE: 02/11/2022

NARRATIVE

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An exit interview was conducted with Licensee Silva Appeal Rights were explained. The licensee was provided a copy of appeal rights (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 Regional Office within 15 business days. First level appeals should be sent to the regional manager to the address listed above.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Pat Rivas	TELEPHONE: 714-703-2800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2022

LIC9099 (FAS) - (06/04)

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