304313614-1-28-2021-06-CC-PMAA-BY5MMU-20210211084430

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 304313614
Report Date: 01/28/2021
Date Signed: 01/28/2021 05:08:30 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
06/18/2020 and conducted by Evaluator Leonor Barajas

COMPLAINT CONTROL NUMBER: 06-CC-20200618085802

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: 5	DATE:	01/28/2021
		UNANNOUNCED	TIME BEGAN:	03:15 PM
MET WITH:	Licensee Michelle Simpson		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

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Facility has an insect infestation.

INVESTIGATION FINDINGS:

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Licensing Program Analyst’s (LPA’s) Barajas conducted a complaint investigation. This is a continuation of the investigation initiated on 05/06/2020, via facetime. LPA met with Licensee Michelle Simpson, who guided LPA on tour of the facility. LPA observed 2 preschool age children, 2 infants sleeping and 1 school age child in day care area with Licensee only. During today’s inspection the facility was operating within its licensed capacity and within compliance of staffing ratios. 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 interviewed Licensee, 5 of 6 Staff members on 04/01/20, 05/06/20, 05/26/20, and 07/27/20 children were also interviewed, reviewed sign in sign out sheets, reviewed personnel files, obtained copy of the Children’s Roster (LIC 9040), conducted two separate Tele inspections of facility via facetime. Based on records reviewed, the licensee was licensed on 06/18/19.
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Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Patricia Magana	TELEPHONE: (714) 743-5149
LICENSING EVALUATOR NAME: Leonor Barajas	TELEPHONE: (714) 292-8628
LICENSING EVALUATOR SIGNATURE:	DATE: 01/28/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2021

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-20200618085802

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: SIMPSON, MICHELLE	FACILITY NUMBER: 304313614
	VISIT DATE: 01/28/2021

NARRATIVE

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The back yard play area is observed to meet licensing regulations. All back yard is cement and dog was observed in lock gated area, next to the garage.

Complaint Party(C/P), reported an allegation: Facility has an insect infestation. CP stated child was bit and was rushed to emergency room. CP stated day care is conducted in backyard and child was bit by a dog flea on 06/18/2020 in bottom of arm, which caused child’s face and arm to become swollen. CP also stated children have recently been bitten a lot in body, therefore provides bug spray to licensee to add to children’s bodies. CP stated children have been bit by fleas since they began attending day care. Complainant party provided LPA with medical records and pictures that indicate child had an allergic reaction to body’s immune system.

During interview conducted with Licensee on 07/28/20, Licensee disclosed has a dog and he is kept in area off limits to children. Licensee stated children play by the dogs enclosed area but do not go inside, its gated. Licensee disclosed she cleans the facility in the morning and afternoon. Licensee stated helps with the cleaning and facility is cleaner now due to Covid-19. Facility is cleaned every day. Licensee disclosed no parents have complained about animals or bites. Licensee disclosed children do not interact with dog. Licensee disclosed its hot, City of Anaheim has pest problem, mosquito and west Nile Virus. Licensee stated everyone gets bit right now due to being hot, its summertime. Licensee disclosed parents have not had concerns or complained of animal bites or insect infestation.

LPA interviewed 3 Parents on 06/25/2020 via phone, all parents did not provide any details or concerns regarding insect infestation. All 3 parents disclosed licensee has a dog in backyard locked inside with a gate. Two parents disclosed children have come home with insect bites in legs, but recently started happening because of hot summer weather. Parents had no concerns with insect infestation.

Based on LPA Barajas observation on 07/28/20 via facetime during facility inspection, no children were observed playing or interacting with dog, dog was inside locked gate. The children were observed playing in clean backyard, with no access to dog. LPA observed gates, and fences that were locked and inaccessible to children in care.

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SUPERVISOR'S NAME: Patricia Magana	TELEPHONE: (714) 743-5149
LICENSING EVALUATOR NAME: Leonor Barajas	TELEPHONE: (714) 292-8628
LICENSING EVALUATOR SIGNATURE:	DATE: 01/28/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2021

LIC9099 (FAS) - (06/04)

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Control Number 06-CC-20200618085802

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: SIMPSON, MICHELLE	FACILITY NUMBER: 304313614
	VISIT DATE: 01/28/2021

NARRATIVE

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Based on the statements provided by Licensee, 3 parents interviewed, medical documents and pictures provided by CP which indicate child had a reaction of the body’s immune system and LPA Barajas visual observation and the information gathered there is not enough evidence to substantiate the facility has an insect infestation, therefore, the allegation was found to be UNSUBSTANTIATED. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation of facility has insect infestation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

Exit interview was conducted with Licensee Michelle Simpson via Facetime. 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. (The "Read Receipt" or licensee's email is in lieu of a signature). First level appeal is to Regional Manager, address is above on the report.

SUPERVISOR'S NAME: Patricia Magana	TELEPHONE: (714) 743-5149
LICENSING EVALUATOR NAME: Leonor Barajas	TELEPHONE: (714) 292-8628
LICENSING EVALUATOR SIGNATURE:	DATE: 01/28/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2021

LIC9099 (FAS) - (06/04)

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