304313514-12-20-2022-06-CC-THOO-CMBU5E-20221221141636

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 304313514
Report Date: 12/20/2022
Date Signed: 12/20/2022 12:35:47 PM

Substantiated

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
10/03/2022 and conducted by Evaluator Stacy Torrence

PUBLIC

COMPLAINT CONTROL NUMBER: 06-CC-20221003171211

FACILITY NAME:	JOHNSTON, YUKARI		FACILITY NUMBER:	304313514
ADMINISTRATOR:	JOHNSTON, YUKARI		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(949) 230-9002
CITY:	IRVINE	STATE: CA	ZIP CODE:	92614
CAPACITY:	14	CENSUS: 6	DATE:	12/20/2022
		UNANNOUNCED	TIME BEGAN:	11:55 AM
MET WITH:	Yukari Johnston, Licensee		TIME COMPLETED:	01:00 PM

ALLEGATION(S):

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Day-care child was bit while in care
Day-care child was left in a soiled diaper for a long period of time.

INVESTIGATION FINDINGS:

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On 12/20/2022, Licensing Program Analyst (LPA) Stacy Torrence conducted an in-person inspection to deliver the findings regarding the above complaint allegations. LPA Torrence met with Licensee Yukari Johnston. During today’s visit, there were also three assistants present. There was a total of 3 children and 3 infants present. A review of staff criminal clearance 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.
On 10/03/2022, Licensing office received a complaint alleging the following: day care child was bit while in care and day care child was left in a soiled diaper for a long period of time. Reporting Party (RP) stated a bite mark was found on the child’s arm during picked up time and the child also received diaper rashes while in care.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Stacy Torrence	TELEPHONE: (714) 300-3599
LICENSING EVALUATOR SIGNATURE:	DATE: 12/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2022

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-20221003171211

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: JOHNSTON, YUKARI	FACILITY NUMBER: 304313514
	VISIT DATE: 12/20/2022

NARRATIVE

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Allegation: day care child was bit while in care:

During the investigation, LPA interviewed 4 staff members including licensee and 4 parents. LPA attempted to interview the children, but no children qualified for an interview.

During the staff interview, licensee stated the following: Parent 1 (P1) texted Licensee about the bite mark. When RP told the staff about the bite mark on 09/12/2022, that’s when they saw it on the Child #1 (C1)’s arm, it was very small couldn’t really see it.
Staff #1 (S1) stated P1 and Adult #1 (A1) notified them of the bite mark 09/12/2022. They didn’t notice anything regarding a bite mark. S1 also stated it looked like a Lego indentation like C1 was lying on it for a long time. Staff #2 (S2) stated seeing a bite mark on C1 on 09/08/2022 when A1 showed it to S2. S2 also stated the biting happened once to the C1 and they didn’t realize it happened until P1 and A1 told them the bite mark was on the C1’s arm around the elbow area. S3 stated seeing a bite mark on the C1 one time on 09/08/2022 after being told by P1 and A1. S2 and S3 did not know how C1 got the bite mark or who bit C1.

During the course of the investigation, LPA Torrence received pictures depicting a bite mark on C1’s arm. After LPA Torrence reviewed the pictures, it was determined the pictures indicated the mark on the child was a bite mark.

LPA Torrence contacted four parents. Interviewed parents had no issues or concerns.

Allegation: day care child was left in a soiled diaper for a long period of time

During the staff interview, S2 stated the following: They change the child’s diapers 3 times a day or whenever the children poop. Diapers are changed in the morning before nap and after nap. Parents bring their own diapers, ointment and wipe, but the facility has extra if needed. A rash was noticed on C1 one time and the parent was immediately notified through a text message. The rash was noticed on C1 after nap. C1 had a bowel movement while C1 was taking a nap and S2 noticed the rash when S2 changed C1’s diaper. P1 disclosed to S2 that C1 had really sensitive skin. P1 also stated to S2 that P1 would put cream on C1 when they get home. S2 did not apply ointment cream or put a diaper on C1, but S2 air dried the rash instead.

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Stacy Torrence	TELEPHONE: (714) 300-3599
LICENSING EVALUATOR SIGNATURE:	DATE: 12/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2022

LIC9099 (FAS) - (06/04)

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Control Number 06-CC-20221003171211

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: JOHNSTON, YUKARI	FACILITY NUMBER: 304313514
	VISIT DATE: 12/20/2022

NARRATIVE

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S3 stated the following: Diapers are changed 3-4 times a day. Parents provide diapers, wipes, and ointment. The facility has some extra just in case. Last month a rash was noticed on C1. S2 changed C1 and showed S3 about the rash. Licensee and staff members stated children nap between an hour and two hours a day.
During the course of the investigation, LPA Torrence received pictures depicting a diaper rash on the C1.

LPA Torrence contacted four parents. Interviewed parents had no issues or concerns.

Based on LPAs interviews and documents review the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 12 & Chapter 1, 102416(f)(1) Reporting Requirement and 102423(a)(2) Personal Rights are being cited on the attached LIC9099D.

If the facility receives a 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. In addition, the licensee shall immediately post upon receipt the Proof of Correction for 30 consecutive days and provide a copy to current and enrolling parents. 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.

Exit interview was conducted. The Notice of Site Visit was posted. Appeal Rights was explained. A copy of appeal rights (LIC 9058 1/16) will be provided through email and their signatures on this form acknowledges receipt of these rights. First level appeal is to Regional Manager, address is above on the report.

End of Report

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Stacy Torrence	TELEPHONE: (714) 300-3599
LICENSING EVALUATOR SIGNATURE:	DATE: 12/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2022

LIC9099 (FAS) - (06/04)

Page: 4 of 4

Control Number 06-CC-20221003171211

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: JOHNSTON, YUKARI	FACILITY NUMBER: 304313514
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 12/20/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 12/21/2022 Section Cited CCR 102417(a)	1 2 3 4 5 6 7	102417(a) Operation of a Family Child Care Home. Licensee shall be present in the home and shall ensure that children in care are supervised at all times. This requirement is not met as evidence by:	1 2 3 4 5 6 7	Per licensee, she will submit a written plan stating will have a meeting with staff regarding Personal Rights and have staff signed as attending, by POC due 12/21/2022
	8 9 10 11 12 13 14	Based on LPA’s interview and pictures reviewed, S2 and S3 disclosed on 09/08/2022 P1 and A1 notified them C1 had a bite mark on the arm. S2 & S3 did not know how C1 got the bite mark. This poses an immediate risk to the health of the children in care.	8 9 10 11 12 13 14
Type A 12/21/2022 Section Cited CCR 102423(a)(2)	1 2 3 4 5 6 7	102423(a)(2) (a) Each child receiving services from a family childcare home shall have certain rights that shall not be waived or abridged by the licensee….. (2) To receive safe, healthful, and comfortable accommodations…… This requirement is not met as evidence by:	1 2 3 4 5 6 7	Per licensee, she will submit a written plan stating will have a meeting with staff regarding Personal Rights and have staff signed as attending, by POC due 12/21/2022
	8 9 10 11 12 13 14	Based on LPAs interviews and pictures reviewed. S2 stated the rash was noticed on C1 when S2 changed C1’s diaper after nap. S3 disclosed last month a rash was noticed on C1. This poses an immediate risk to the health of the children in care.	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: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Stacy Torrence	TELEPHONE: (714) 300-3599
LICENSING EVALUATOR SIGNATURE:	DATE: 12/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2022

LIC9099 (FAS) - (06/04)

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