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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304370327
Report Date: 03/29/2023
Date Signed: 03/29/2023 08:50:52 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 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
03/06/2023 and conducted by Evaluator Dean Thompson
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20230306111932
FACILITY NAME:EVERBROOK ACADEMYFACILITY NUMBER:
304370327
ADMINISTRATOR:LARSON, RUTHFACILITY TYPE:
850
ADDRESS:30722 RICHARD REESE WAYTELEPHONE:
(949) 888-7274
CITY:RANCHO SAN MARGARITASTATE: CAZIP CODE:
92688
CAPACITY:117CENSUS: 28DATE:
03/29/2023
UNANNOUNCEDTIME BEGAN:
07:55 AM
MET WITH:Kim San JoseTIME COMPLETED:
09:10 AM
ALLEGATION(S):
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staff do not report incidents to responsible parties in a timely manner
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Thompson conducted an unannounced complaint investigation. This is a continuation of the investigation initiated on 3/7/2023. Upon arrival LPA met with Assistant Director Kim San Jose, to deliver complaint findings. LPA on a tour of the facility. LPA observed a total of 28 Preschool children with 5 staff.

A review of the Facility Personnel Report Summary on this date indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. During the visit, it was determined the facility is operating within its licensed capacity and within compliance of staffing ratios.

On 3/6/2023 the Orange County Child Care Office received a complaint alleging staff do not report incidents to responsible parties in a timely manner.

Continue to Page 2
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Judy HansonTELEPHONE: (714) 795-0415
LICENSING EVALUATOR NAME: Dean ThompsonTELEPHONE: (714) 287-0708
LICENSING EVALUATOR SIGNATURE:

DATE: 03/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 5
Control Number 06-CC-20230306111932
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: EVERBROOK ACADEMY
FACILITY NUMBER: 304370327
VISIT DATE: 03/29/2023
NARRATIVE
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On 3/7/2023 LPA conducted interviews with Director, six staff, and reviewed children records. Director stated having three children out with hand, foot, and mouth disease around a month or two ago. Three out of six staff interviewed stated hearing about hand, foot, and mouth at the facility, and one out of three staff mentioned observing a child with hand, foot, and mouth disease. LPA reviewed children files and observed Child (C1) was under medical care with hand, foot, and mouth disease on 2/6/2023. Child (C2) was placed under medical care with hand, foot, and mouth disease on 2/10/23.

In the course of the investigation, it was discovered, the Director did not report Hand, Food, and Mouth disease outbreak that occurred on 2/6/2023 and 2/10/23. LPA asked Director if she recall reporting Hand, Food, and Mouth cases to licensing, Director stated “I did not report it, I sent a bulletin to parents.”

California Code of Regulations, Title 22, Division 12, Chapter 1, 101212 Reporting Requirements (d) Upon the occurrence, during the operation of the childcare center of any of the events specified in (d)(1) below, a report shall be made to the Department by telephone or fax within the Department's next working day and during its normal business hours. In addition, a written report containing the information specified in (d)(2) below shall be submitted to the Department within seven days following the occurrence of such event. (1) Events reported shall include the following: (E) Epidemic outbreaks. is being cited on the attached LIC 809D



Based on LPA interviews with director, staff, and children file reviews it has been determined staff do not report incidents to responsible parties in a timely manner. Therefore, the preponderance of evidence standard has been met, the allegations are found to be Substantiated.

Exit interview conducted and report was reviewed with the Assistant Director Kim San Jose. A notice of site visit was given and must remain posted for 30 days.



Appeal Rights and deficiencies were discussed. The facility representative was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days.
SUPERVISOR'S NAME: Judy HansonTELEPHONE: (714) 795-0415
LICENSING EVALUATOR NAME: Dean ThompsonTELEPHONE: (714) 287-0708
LICENSING EVALUATOR SIGNATURE:

DATE: 03/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 06-CC-20230306111932
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: EVERBROOK ACADEMY
FACILITY NUMBER: 304370327
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/29/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/12/2023
Section Cited
CCR
101212(d)(1)(E)
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101212 Reporting Requirements (d) Upon the occurrence, during the operation of the child care center of any of the events specified in (d)(1) below, a report shall be made to the Department by telephone or fax within the Department's next working day and during its normal business hours. In addition, a written report containing the information specified in (d)(2) below shall be submitted to the Department within seven days following the occurrence of such event. (1) Events reported shall include the following: (E) Epidemic outbreaks.
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Director agreed to report unusual incident within 24 hour and in writing within 7 days to licensing. Director agreed to submit the LIC624 UIR for the Hand, Foot, Mouth diseases.
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Based on observations and interviews, Director did not report cases of hand, foot, mouth disease that occurred on 2/6/23 and 2/10/23 at the childcare center to licensing office or department of public health. This poses a potential risk to the health and safety of the children in care.
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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 HansonTELEPHONE: (714) 795-0415
LICENSING EVALUATOR NAME: Dean ThompsonTELEPHONE: (714) 287-0708
LICENSING EVALUATOR SIGNATURE:

DATE: 03/29/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2023
LIC9099 (FAS) - (06/04)
Page: 5 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 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
03/06/2023 and conducted by Evaluator Dean Thompson
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20230306111932

FACILITY NAME:EVERBROOK ACADEMYFACILITY NUMBER:
304370327
ADMINISTRATOR:LARSON, RUTHFACILITY TYPE:
850
ADDRESS:30722 RICHARD REESE WAYTELEPHONE:
(949) 888-7274
CITY:RANCHO SAN MARGARITASTATE: CAZIP CODE:
92688
CAPACITY:117CENSUS: 28DATE:
03/29/2023
UNANNOUNCEDTIME BEGAN:
07:55 AM
MET WITH:Kim San JoseTIME COMPLETED:
09:10 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff do not inspect daycare children for illness
INVESTIGATION FINDINGS:
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5
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Licensing Program Analysts (LPAs) Thompson conducted an unannounced complaint investigation. This is a continuation of the investigation initiated on 3/7/2023. Upon arrival LPA met with Assistant Director Kim San Jose , to deliver complaint findings. Director guided LPA on a tour of the facility. LPA observed a total of 28 Preschool children with 5 staff.

A review of the Facility Personnel Report Summary on this date indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. During the visit, it was determined the facility is operating within its licensed capacity and within compliance of staffing ratios.

On 3/6/2023 the Orange County Child Care Office received a complaint Staff do not inspect daycare children for illness.

Continue to page 2
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Judy HansonTELEPHONE: (714) 795-0415
LICENSING EVALUATOR NAME: Dean ThompsonTELEPHONE: (714) 287-0708
LICENSING EVALUATOR SIGNATURE:

DATE: 03/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 06-CC-20230306111932
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: EVERBROOK ACADEMY
FACILITY NUMBER: 304370327
VISIT DATE: 03/29/2023
NARRATIVE
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Page 2

On 3/7/2023 upon entry at 9:00 AM, LPA met with Director Ruth Larson and observed child (C1) sitting on a buggy inside the lobby with the director. Director stated child (C1) was not feeling well and is sitting up front with her until the parents arrive for pick up. Child (C1) was observed being isolated from other children in care.

On 3/7/2023 LPA conducting interviews with Director, six staff, and reviewed children records. LPA asked all six staff including Director, are wellness checks conducting at the center. All six staff and Director answered “yes” and gave examples on how wellness checks are being conducted. Staff stated they observed the children and look for redness, runny nose, coughing, and fever. Two staff stated they conduct temperature checks. All staff stated when a child is sick, they notify the director and then the child is removed from the classroom. Child parents are then notified and isolated from other children until parents arrive for pick up.

Based on LPA observations, and interviews which were conducted with Director and six staff, the preponderance of evidence was not met, therefore the above allegations are found to be UNSUBSTANTIATED. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegations are UNSUBSTANTIATED.

Exit interview conducted and report was reviewed with Assistant Director Kim San Jose. A notice of site visit was given and must remain posted for 30 days.



Appeal Rights were discussed. The facility representative was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days.
SUPERVISOR'S NAME: Judy HansonTELEPHONE: (714) 795-0415
LICENSING EVALUATOR NAME: Dean ThompsonTELEPHONE: (714) 287-0708
LICENSING EVALUATOR SIGNATURE:

DATE: 03/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2023
LIC9099 (FAS) - (06/04)
Page: 4 of 5