304370328-2-25-2025-06-CC-NKTN-DEC2TH-20250228164044

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 304370328
Report Date: 02/25/2025
Date Signed: 02/25/2025 02:21:36 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY CC RO, 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
01/29/2025 and conducted by Evaluator Dean Thompson

PUBLIC

COMPLAINT CONTROL NUMBER: 06-CC-20250129124316

FACILITY NAME:	EVERBROOK ACADEMY		FACILITY NUMBER:	304370328
ADMINISTRATOR:	LARSON, RUTH		FACILITY TYPE:	830
ADDRESS:	30722 RICHARD REESE WAY		TELEPHONE:	(949) 888-7274
CITY:	RANCHO SAN MARGARITA	STATE: CA	ZIP CODE:	92688
CAPACITY:	32	CENSUS: 11	DATE:	02/25/2025
		UNANNOUNCED	TIME BEGAN:	01:25 PM
MET WITH:	Ruth Larson		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

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Staff do not inspect children for illness prior to acceptance into facility.
Staff operates out of ratio.

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPA) Thompson conducted an unannounced complaint investigation. This is a continuation of the investigation initiated on 2/4/2025. Upon arrival LPA met with Director Ruth Larson, to deliver complaint findings. LPA toured the facility inside and outside. LPA observed a total of three infant age children with one infant staff and eight napping toddlers along with one 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 today’s inspection and on 2/4/2025, the facility was operating within its licensed capacity and within compliance of staffing ratios.

On 1/29/2025, the Orange County Childcare Office received a complaint alleging (1) Staff do not inspect children for illness prior to acceptance into facility and (2) Staff operates out of ratio.

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Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Nguyen K Tran
LICENSING EVALUATOR NAME: Dean Thompson
LICENSING EVALUATOR SIGNATURE:	DATE: 02/25/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2025

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-20250129124316

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: EVERBROOK ACADEMY	FACILITY NUMBER: 304370328
	VISIT DATE: 02/25/2025

NARRATIVE

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During the investigation, LPA interviewed four staff, interviewed four parents, obtained the facility roster, and retrieve copies of pages 31 and 32 from the parent handbook.

Staff do not inspect children for illness prior to acceptance into facility. On 2/4/2025, LPA interviewed four staff that were present inside the infant program. Staff interviewed stated they conduct well-ness checks for children daily. Staff interviewed stated the checks are conducting via observation during drop off, during diaper changing, and throughout the day. Staff stated if a child has a runny nose, coughing, constantly crying, or not acting normal, they check the temperature of the child. If the child has a fever or is sick, the child is taken up front to the office and parents are called. On page 31, inside the parent handbook it reads “we will observe each child’s heath daily.” On page 32, inside the parent handbook it reads “If we observe your child developing symptoms of illness during the day we will separate him or her from other children to rest comfortably and be monitored by a staff member.”

On 2/14/2025, LPA conducted parent interviews via phone call. LPA contacted 12 parents, and four out of 12 parents were able to be interviewed. Parents interviewed did not divulge any information pertaining to the allegation (1) staff do not inspect children for illness prior to acceptance into facility.

Staff operates out of ratio. On 2/4/2025, LPA interviewed four staff that were present inside the infant program. Staff interviewed knew what the staff to child ratio is for the infant program. Staff interviewed stated they have not been out ratio and have not witnessed other staff being out of ratio. During LPA visits on 2/4/2025 and 2/25/2025, LPA did not observe staff being out of ratio.

Children were not interviewed due to age and being non-verbal.

Based LPA observation on 2/4/2025 and 2/25/2025, interviews with four staff, interviews with four parents, and information provided in the parent handbook there was not enough evidence to substantiate the allegations.

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SUPERVISORS NAME: Nguyen K Tran
LICENSING EVALUATOR NAME: Dean Thompson
LICENSING EVALUATOR SIGNATURE:	DATE: 02/25/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2025

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 06-CC-20250129124316

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: EVERBROOK ACADEMY	FACILITY NUMBER: 304370328
	VISIT DATE: 02/25/2025

NARRATIVE

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The Orange County Childcare Office has investigated the complaint alleging (1) Staff do not inspect children for illness prior to acceptance into facility and (2) Staff operates out of ratio: although the allegations may have happened or are valid, there is not enough preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED.

In the areas that were evaluated, no deficiencies were observed of the California Code of Regulations, Title 22, Division 12 at the time of the visit. Exit interview conducted and report was reviewed with Director Ruth Larson.

Notice of Site Visit was provided to Director Ruth Larson and posted on the door. The notice of site visit must be posted for 30 consecutive days. Failure to post will result in civil penalties of $100. The licensee was provided a copy of their appeal rights (LIC 9058 1/16) and their signature on this form acknowledges receipt of these rights.

SUPERVISORS NAME: Nguyen K Tran
LICENSING EVALUATOR NAME: Dean Thompson
LICENSING EVALUATOR SIGNATURE:	DATE: 02/25/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2025

LIC9099 (FAS) - (06/04)

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