304312398-9-26-2019-06-CC-RLOZ-BGJRE6-20191001125703

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 304312398
Report Date: 09/26/2019
Date Signed: 09/26/2019 10:46:13 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
07/05/2019 and conducted by Evaluator Sherene Hawkins

PUBLIC

COMPLAINT CONTROL NUMBER: 06-CC-20190705172657

FACILITY NAME:	KADRIE, DEBORAH ANN		FACILITY NUMBER:	304312398
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 6	DATE:	09/26/2019
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Deborah Kadrie		TIME COMPLETED:	11:15 AM

ALLEGATION(S):

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Child sustained unexplained injuries while in care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Hawkins conducted a follow up investigation to deliver the findings regarding the above complaint allegation which was initiated on 7/12/19. LPA met with Licensee, Deborah Kadrie. Present was licensee who was caring for six day-care children, of whom three were under two years of age. 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.

The Department received a complaint alleging neglect/lack of supervision resulting in unexplained injuries to child while in care. This complaint investigation has been conducted by Andrew Murrow from the Investigation Branch (IB) with our Department. The investigator interviewed the child's parents, two staff, pediatrician, two children, other agencies involved in this case, and have obtained child’s medical records and police reports regarding this allegation. Parents report child did not arrive at the facility with the marks on his neck and sustained the marks at some point at the facility. Licensee speculated the marks were possibly caused by a pack and play being faulty
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Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Judy Hanson	TELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Sherene Hawkins	TELEPHONE: (949) 466-1624
LICENSING EVALUATOR SIGNATURE:	DATE: 09/26/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2019

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 3

Control Number 06-CC-20190705172657

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: KADRIE, DEBORAH ANN	FACILITY NUMBER: 304312398
	VISIT DATE: 09/26/2019

NARRATIVE

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and the Velcro possibly scratched him during nap time. Licensee added she tended to the child during nap time and soothed him due to child’s crying. Licensee stated at no other time did child show signs of distress and she did not witness child being struck by anyone.

Based on further evaluation of the child’s medical records, it was determined the marks on child were treated and classified as Ecchymosis (bruising). Doctor reported that the marks on child’s neck could only be caused by some sort of force striking his neck and added that the Velcro could not have caused the injury.

This agency has investigated the complaint regarding neglect/lack of supervision resulting in unexplained injuries to child while in care. Based on information gathered and conflicting statements received during the investigation and interviews, the neglect/lack of supervision allegation is determined to be unsubstantiated. While the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur.

During the course of the investigation, it was discovered the Licensee failed to notify the Community Care Licensing (CCL) Regional Office Child Care about a child who received medical attention as required by regulations of alleged incident which occurred on or about 6/24/19, investigated by Investigator Murrow and found to be unsubstantiated. LPA Hawkins informed Licensee Title 22 regulations require any reportable incidents to be reported to CCL within 24 hours and a written incident report is to be submitted to CCL within 7 days. Licensee failed to comply with the above regulations, the facility is being cited for Reporting Requirements Section 102416.2(b)(1) of the California Code of Regulations, Title 22, Division 12.

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. Appeal Rights explained. A copy of their appeal rights (LIC 9058) was given and signatures on this form acknowledges receipt of these rights. All appeals must be in writing and received by the licensing office within 15 business days. The first level appeal is to regional manager; address is above on the report. Exit interview was conducted.

Copies of provider's guide to safe sleep and Never Ever Shake a Baby pamphlets were provided to the facility representative.

SUPERVISOR'S NAME: Judy Hanson	TELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Sherene Hawkins	TELEPHONE: (949) 466-1624
LICENSING EVALUATOR SIGNATURE:	DATE: 09/26/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2019

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 06-CC-20190705172657

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: KADRIE, DEBORAH ANN	FACILITY NUMBER: 304312398
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/26/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 10/03/2019 Section Cited CCR 102416.2(b)(1)	1 2 3 4 5 6 7	102416.2(b)(1) Reporting Requirement: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.Medical treatment means treatment by a medical professional...Licensee stated she was not made aware of child	1 2 3 4 5 6 7	The licensee stated she acknowledges that she is required to report incidents to the licensing office within 24 hours. During the inspection, the licensee read through reporting requirement regulation. Licensee has signed the regulations, and the signed copy of the regulation was obtained for the file
	8 9 10 11 12 13 14	receiving medical attention until investigator informed her after the complaint was initiated. This requirement was not met as evidenced by Licensee failed to notify (CCL) about a child who received medical attention as required by regulations of alleged incident...This is a potential risk to the health and safety of children in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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 Hanson	TELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Sherene Hawkins	TELEPHONE: (949) 466-1624
LICENSING EVALUATOR SIGNATURE:	DATE: 09/26/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2019

LIC9099 (FAS) - (06/04)

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