304312693-4-14-2021-06-CC-JHAN-C29M5H-20210420091819

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 304312693
Report Date: 04/14/2021
Date Signed: 04/14/2021 12:13:49 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
04/07/2021 and conducted by Evaluator Dean Valencia

PUBLIC

COMPLAINT CONTROL NUMBER: 06-CC-20210407111353

FACILITY NAME:	SULEIMAN, RANA		FACILITY NUMBER:	304312693
ADMINISTRATOR:	SULEIMAN, RANA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(949) 293-2690
CITY:	IRVINE	STATE: CA	ZIP CODE:	92620
CAPACITY:	14	CENSUS: 8	DATE:	04/14/2021
		UNANNOUNCED	TIME BEGAN:	10:15 AM
MET WITH:	Rana Suleiman		TIME COMPLETED:	01:00 PM

ALLEGATION(S):

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Child in care was left unsupervised.
Gate to backyard does not latch.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Dean Valencia conducted an unannounced complaint inspection on today's date, 4/14/2021. LPA met with licensee, Rana Suleiman, who guided LPA on a tour of the facility and census of children was documented. 8 children, 2 of which are infants were in care, and an adult was present available to assist the licensee. During today’s inspection it was observed the facility was operating within its licensed capacity and within compliance of ratios. On 4/7/2021 a complaint was filed with the Department alleging (1) Child in care was left unsupervised. (2) Gate to backyard does not latch. During the course of the investigation, LPA interviewed licensee, an adult #1/assistant (see Confidential Names List LIC811), and made a physical inspection.
During the interviews with licensee and adult #1, it was disclosed that the licensee was supervising 7 children in the backyard, and adult #1 switched supervision with licensee who came in to tend to the kitchen. At that time, child #1, who was playing in the backyard exited the backyard through an ajar side gate and was in the front yard for approximately one minute. (continued on LIC9099C)

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Judy Hanson	TELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Dean Valencia	TELEPHONE: (714) 215-6737
LICENSING EVALUATOR SIGNATURE:	DATE: 04/14/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/14/2021

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-20210407111353

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: SULEIMAN, RANA	FACILITY NUMBER: 304312693
	VISIT DATE: 04/14/2021

NARRATIVE

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Soon after parent of C1 arrived to pick up, and brought C1 inside. Just prior to parent ringing doorbell, licensee had been looking for C1 in the backyard. Based on information obtained from interview with reporting party, licensee, and adult #1 it was determined that C1 was unsupervised for approximately one minute.

LPA observed that the gate that was left ajar which C1 exited, had a key lock placed on it to prevent the gate from being left open again in the future. LPA observed that the gate without the key lock on it, is in disrepair and very difficult to close and latch. This observation and information was confirmed with interview with licensee and adult #1.

Based on the interviews with licensee, and adult #1, LPA has determined the C1 was unsupervised in the front yard for approximately 1 minute and the side gate was in disrepair. These allegations have been substantiated. This constitutes a violation of operation of Family Child Care Home Title 22 Regulation code 102417(a), and an immediate civil penalty has been assessed. In addition, a violation of Operation of Family Child Care Home Title 22 Regulation 102417(g) has been issued. Based on this gathered information, the preponderance of evidence standard has been met, and therefore the above allegations are found to be substantiated.

Due to the two Type A violations cited today, the licensee must 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 licensee is to keep Acknowledgement Receipt (LIC 9224) signed by parents in each child’s file. In addition, the licensee shall immediately post upon receipt the Proof of Correction for 30 consecutive days. The Licensee was provided a copy of appeal rights and their signature on this form acknowledges receipt of these rights. The licensee was also provided a copy of Operation of FCCH Title 22 Regulations, and reviewed these regulations with the licensee.

SUPERVISOR'S NAME: Judy Hanson	TELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Dean Valencia	TELEPHONE: (714) 215-6737
LICENSING EVALUATOR SIGNATURE:	DATE: 04/14/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/14/2021

LIC9099 (FAS) - (06/04)

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Control Number 06-CC-20210407111353

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: SULEIMAN, RANA	FACILITY NUMBER: 304312693
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/14/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 04/14/2021 Section Cited CCR 102417(a)	1 2 3 4 5 6 7	The licensee shall be present in the home and shall ensure that children in care are supervised at all times...102417(a) This was not met as evidenced by: During interview with licensee and adult #1, it was disclosed that the licensee was supervising 7 children in the backyard,	1 2 3 4 5 6 7	The licensee has since installed a key lock on the gate that was left ajar. Licensee has stated that this incident was a single occurance and will not happen again. Licensee has increase vigilance of supervision and ensures that all children are supervised at all times. Licensee has agreed to email LPA a written statement acknowledging the
	8 9 10 11 12 13 14	and adult #1 switched supervision with licensee who came in to tend to the kitchen. At that time, child #1, who was playing in the backyard exited the backyard through an ajar side gate and was in the front yard for approximately one minute. This is an immediate threat to the children's health and safety.	8 9 10 11 12 13 14	violation and how the licensee will prevent from a similar absence of supervision occuring again in the future.The licensee was also provided a copy of Operation of FCCH Title 22 Regulations, and reviewed these regulations with the licensee. An immediate civil penalty was assessed.
Type A 04/14/2021 Section Cited CCR 102417(g)	1 2 3 4 5 6 7	The home shall be free from defects or conditions which might endanger a child...102417(g) This was not evidenced by: During interview with licensee and adult #1, it was disclosed that achild #1, who was playing in the backyard exited the backyard through an	1 2 3 4 5 6 7	The licensee has since installed a key lock on the gate that was left ajar. Licensee has stated that this incident was a single occurance and will not happen again. Photo proof of the correction was obtained by LPA.The licensee was also provided a copy of Operation of FCCH Title 22 Regulations, and reviewed these regulations with the licensee.
	8 9 10 11 12 13 14	ajar side gate and was in the front yard for approximately one minute. Gate was in disrepair and very difficult to close prior to a key lock being added on to it. This gate being in disrepair presented an immediate threat to the children's health and safety.	8 9 10 11 12 13 14

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: Dean Valencia	TELEPHONE: (714) 215-6737
LICENSING EVALUATOR SIGNATURE:	DATE: 04/14/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/14/2021

LIC9099 (FAS) - (06/04)

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