304370176-4-14-2021-06-CC-THOO-C23RLZ-20210414130759

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 304370176
Report Date: 04/13/2021
Date Signed: 04/14/2021 12:57:19 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
12/28/2020 and conducted by Evaluator Stacy Torrence

PUBLIC

COMPLAINT CONTROL NUMBER: 06-CC-20201228142710

FACILITY NAME:	LA HABRA HERITAGE SCHOOL		FACILITY NUMBER:	304370176
ADMINISTRATOR:	WIJEGUNARATNE, DEEPIKA		FACILITY TYPE:	840
ADDRESS:	323 NORTH EUCLID STREET		TELEPHONE:	(562) 691-1967
CITY:	LA HABRA	STATE: CA	ZIP CODE:	90631
CAPACITY:	17	CENSUS: 8	DATE:	04/13/2021
		UNANNOUNCED	TIME BEGAN:	03:00 PM
MET WITH:	Deepika Wijegunaratne, Director		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

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Staff did not provide medical attention to day care child

INVESTIGATION FINDINGS:

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On 04/13/2021, Licensing Program Analyst (LPA) Torrence conducted a tele-inspection to deliver the findings regarding the above complaint allegation. This complaint investigation had been started on 12/28/2020 by LPA Tina Nguyen. LPA Torrence met with director Deepika Wijegunaratne remotely via FaceTime application. LPA notified the director that due to Covid-19 and Department of Public Health (DPH) guidelines of social distancing, a tele investigation is conducted. The Covid-19 Emergency Response questionnaires were asked.
There was a total of eight school age children with one staff observed remotely. 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.

Unsubstantiated

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: 04/13/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/13/2021

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-20201228142710

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: LA HABRA HERITAGE SCHOOL	FACILITY NUMBER: 304370176
	VISIT DATE: 04/13/2021

NARRATIVE

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On 12/28/2020, the office received a complaint and complainant reported that a staff member refused to help a child when the child had a bloody nose.

LPA Nguyen conducted interview with five staff members. No disclosures were made by staff members to LPA Nguyen. All interviewed staff members denied witnessing any staff member did not respond to the children when they got bleeding nose. All interviewed staff members stated if the children get bleeding nose at the school, the teachers will clean the nose and ask children to sit down until the bleeding stop.

LPA Nguyen contacted six parents and was able to interview one parent. The interviewed parent stated they did not have any concern or issue with the facility.

LPA Nguyen conducted interviews with 6 children and able to interview 5 children. No disclosures were made by children. All interviewed children disclosed they like going to the school. The children also stated if the children got hurt, the staff would check out the injury areas, clean it, and also ask children to sit down.

Based on the interviews conducted and reviewing records, there is insufficient evidence to corroborate the allegation. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged staff did not provide medical attention to day care child did or did not occur, therefore the allegation is UNSUBSTANTIATED.

Exit interview was conducted. The Notice of Site Visit was not posted due to tele-investigation Covide-19 State of Emergency. 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. All appeals must be in writing and received by the licensing office within 15 business days.

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Stacy Torrence	TELEPHONE: (714) 300-3599
LICENSING EVALUATOR SIGNATURE:	DATE: 04/13/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/13/2021

LIC9099 (FAS) - (06/04)

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