304313614-12-23-2020-06-CC-LBAS-BWL3EY-20201223171155

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304313614
Report Date: 12/23/2020
Date Signed: 12/23/2020 05:12:11 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME:	SIMPSON, MICHELLE		FACILITY NUMBER:	304313614
ADMINISTRATOR:	SIMPSON, MICHELLE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(562) 650-8174
CITY:	ANAHEIM	STATE: CA	ZIP CODE:	92805
CAPACITY:	14	CENSUS: 0	DATE:	12/23/2020
TYPE OF VISIT:	Case Management - Other	UNANNOUNCED	TIME BEGAN:	02:50 PM
MET WITH:	Licensee Michelle Simpson		TIME COMPLETED:	03:15 PM

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25

Tele-Visit
An unannounced Case Management Investigation was initiated on this date by Licensing Program Analyst (LPA) Barajas. This is a continuation of the investigation initiated on 05/06/2020 and 07/28/2020. Based on information discovered during an inspection and interviews for an unrelated complaint investigation.

LPA met with Licensee Michelle Simpson, who guided LPA on tour of the facility. There were no children present, day care was closed. 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 Barajas interviewed 4 of 6 staff via facetime who disclosed a child did not want to sleep during nap time therefore ran out of the facility to the front yard. A staff disclosed child was upset as child did not want to nap. Another staff disclosed a Staff called Licensee via phone so she can tell the child to fall asleep,but child began to yell that he was older and didn’t want to nap. Staff stated child refused to nap.

During the investigation, LPA Barajas also interviewed 4 of 6 parents via phone. Two parents disclosed staff forced children to sleep during nap time. Two other parents disclosed licensee forces children to sleep during nap time, and if they don't fall asleep child gets in trouble or placed in time out. Another parent disclosed child was being forced to sleep and licensee was yelling at the child over the phone which prompted child to run out of the facility.

No children were interviewed due to age and being nonverbal, and parents requesting not to have their child interviewed.

Based on interviews conducted via phone with 4 of 6 staff and 4 of 6 parents who all disclosed staff force children to sleep during nap time, has determined that children’s personal rights have been violated.

Page 1, Continued on Page 2

SUPERVISOR'S NAME: Patricia Magana	TELEPHONE: (714) 743-5149
LICENSING EVALUATOR NAME: Leonor Barajas	TELEPHONE: (714) 292-8628
LICENSING EVALUATOR SIGNATURE:	DATE: 12/23/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/23/2020

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION 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: SIMPSON, MICHELLE	FACILITY NUMBER: 304313614
	VISIT DATE: 12/23/2020

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Page 2, Continued from Page 1

Facility will be cited: Personal Rights

California Code of Regulations, Title 22, Division 12, Chapter 1, Section 102423(a)(4) is being cited on the attached LIC 809D.

102423(a)(4)Personal Rights: (a) Each child receiving services from a family childcare home shall have certain rights that shall not be waived or abridged by the licensee regardless of consent or authorization from the child's authorized representative. These rights include, but are not limited to, the following: (4)To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature, including, but not limited to: interference with eating, sleeping or toileting; or withholding shelter, clothing, medication or aids to physical functioning.

This report cites a Type A violation and shall be provided to parents/guardians of children currently in enrolled and to parents/guardians of children newly enrolled at the facility during the next 12 months. Parents/guardians must sign Form (LIC 9224) to be kept in each child's file.

Exit interview was conducted with Licensee Michelle Simpson via Tele-Inspection. Report was read to Licensee. A copy of the report along with Appeal Rights will be emailed to Licensee with a Read Receipt to acknowledge report was received. If Read Receipt is not functional, Licensee will respond to email stating “I have read and received the report, I acknowledge receipt.” LIC 9099 will also be mailed if those options are not available.

End of Report.

SUPERVISOR'S NAME: Patricia Magana	TELEPHONE: (714) 743-5149
LICENSING EVALUATOR NAME: Leonor Barajas	TELEPHONE: (714) 292-8628
LICENSING EVALUATOR SIGNATURE:	DATE: 12/23/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/23/2020

LIC809 (FAS) - (06/04)

Page: 2 of 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION 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: SIMPSON, MICHELLE	FACILITY NUMBER: 304313614
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 12/23/2020

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 12/23/2020 Section Cited	1 2 3 4 5 6 7	102423(a)(4)Personal Rights: (a) Each child receiving services from a family childcare home shall have certain rights that shall not be waived ...These rights ..., (4)To be free from corporal or unusual punishment, ...: interference with eating, sleeping or toileting; or withholding shelter, clothing...This requirement is not met as evidenced by:
	8 9 10 11 12 13 14	Based on interviews conducted via phone with 4 of 6 staff and 4 of 6 parents who all disclosed staff force children to sleep during nap time, has determined that children’s personal rights have been violated. This is an immediate risk to the safety of the children in care.	8 9 10 11 12 13 14
	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: Patricia Magana	TELEPHONE: (714) 743-5149
LICENSING EVALUATOR NAME: Leonor Barajas	TELEPHONE: (714) 292-8628
LICENSING EVALUATOR SIGNATURE:	DATE: 12/23/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/23/2020

LIC809 (FAS) - (06/04)

Page: 3 of 3