304370547-2-11-2021-06-CC-PMAA-BY5RU6-20210211121926

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 304370547
Report Date: 02/11/2021
Date Signed: 02/11/2021 11:05:29 AM

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
03/13/2020 and conducted by Evaluator Leonor Barajas

PUBLIC

COMPLAINT CONTROL NUMBER: 06-CC-20200313121824

FACILITY NAME:	SAUSD/DAVIS ELEM. SCHOOL-KINDER READINESS PROGRAM		FACILITY NUMBER:	304370547
ADMINISTRATOR:	MEDRANO, PATRICIA		FACILITY TYPE:	850
ADDRESS:	1405 FRENCH STREET		TELEPHONE:	(714) 564-2200
CITY:	SANTA ANA	STATE: CA	ZIP CODE:	92701
CAPACITY:	48	CENSUS: 0	DATE:	02/11/2021
		UNANNOUNCED	TIME BEGAN:	08:20 AM
MET WITH:	Director Laura Barnett		TIME COMPLETED:	09:30 AM

ALLEGATION(S):

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Lack of supervision resulting in day care child sustaining injuries.
Staff did not notify authorized representative of day care child's injuries.

INVESTIGATION FINDINGS:

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Covid 19 Tele Inspection
Licensing Program Analyst (LPA), Leonor Barajas conducted a follow up complaint investigation on today’s date from an initial investigation conducted on 05/12/2020 via Tele inspection. Complaint was conducted with Director Laura Barnett via facetime. LPA did not conduct a facility inspection as facility was not in session, there were 0 children present. 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, Reporting Party, Director, three staff, LPA attempted to interview children but was unable qualify any of the children to be interviewed due to school being out of session. LPA reviewed children’s and staff’s records, requested copies of incident reports, ouch and behavior, records, Personnel Report (LIC 500), requested copy of children’s roster (LIC 9040), and took pictures of day care facility.
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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: 02/11/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2021

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-20200313121824

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: SAUSD/DAVIS ELEM. SCHOOL-KINDER READINESS PROGRAM	FACILITY NUMBER: 304370547
	VISIT DATE: 02/11/2021

NARRATIVE

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An allegation: Lack of supervision resulting in day care child sustaining injuries. RP stated child came home with bruises on shoulders and bumps in forehead. RP stated child was stabbed in shoulder with knife. RP stated child disclosed injuries at home while taking a bath. RP stated does not know if injuries occurred at day care or at the babysitters house.

During interview conducted with Director on 05/12/2020. Director stated facility maintains supervision by moving around in different areas, scanning, assigned different areas in classroom so staff can cover all areas possible. The children are placed in small groups. Director stated there is three staff inside classroom with 24 children. Supervision outdoors is similar, staff are assigned different area in playground walking playground, scanning, teacher A, B and TA, teachers have designated areas, if staff needs to step away from area, another staff comes and covers. Director disclosed staff report injuries to parents by providing an accident/ouch report if medical attention was provided, but if small injury only notify parent at pick up time, an injury report is provided to parent, carbon copy is kept in child’s file. Director stated child has not been at facility since the allegation was reported and the child’s accidental injury. Director stated child had behavioral issues when child first began school. Child would talk about feelings, staff tried to teach child not to hit other children. Director stated Parent never reported injuries or concerns regarding child. Director stated Staff stated injuries never occurred at facility. Director stated she communicated with the parent about allegations via email on 01/14/2020. Director provided LPA with copy of email.

During the investigation, LPA interviewed 3 staff separately, LPA attempted to interviewed children, but none of the children qualified to be interviewed and facility is closed due to COVID 19. During interviews conducted on 05/14/2020, all Staff interviewed stated they maintain supervision by walking around room, rotate around areas a staff supervises blocked, house and computer areas, staff always have a visual of classroom area. Outdoors supervision is maintained the same way, all teachers are always outdoors . All split in 3 areas, rotate, scan area and move around, 20 ft apart. All three staff disclosed class was walking back to the classroom around 11:30am, when alleged child accidentally ran into podium/pillar. Staff disclosed usually a teacher walks in front and another in the back of line. All staff disclosed child bumped forehead and an incident report was provided to parent at pick up time and notified babysitter. Staff disclosed heard child say “ouch “at time of injury. All staff disclosed injuries are reported to parents verbally or in writing.
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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: 02/11/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2021

LIC9099 (FAS) - (06/04)

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Control Number 06-CC-20200313121824

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: SAUSD/DAVIS ELEM. SCHOOL-KINDER READINESS PROGRAM	FACILITY NUMBER: 304370547
	VISIT DATE: 02/11/2021

NARRATIVE

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Based on the information provided to LPA Barajas by RP, Director, three staff and the inability to interview additional children due to school being closed, there was insufficient evidence to determine if there was lack of supervision, which resulted in a day care child sustaining injury to be substantiated. Based on interviews conducted with staff, all disclosed separately that child injured forehead accidentally in podium/pillar while walking back to class. Although the lack of supervision allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

A Second Allegation: Staff did not notify authorized representative of day care child’s injuries. RP stated no ouch report or phone call was provided. RP stated was scheduled to have a meeting with the Education Specialist but was busy trying to move child to new program. RP acknowledged receiving ouch reports for other incidents not related to allegation. RP stated two staff verbally notified of the forehead injury.

During interview conducted with Director on 05/12/2020, Director disclosed staff report injuries to parents with accident report, given to parent daily if medical attention is needed, they call parent immediately but if only injury they let parent know at pick up time. An injury report is given to parent a carbon copy is kept in child’s file. Director provided copies of ouch reports to LPA.

During the investigation, LPA interviewed three staff separately on 05/14/2020. All staff stated injuries are reported to parents at pick up time. A staff disclosed spoke to parent about incident the next day at pick up time as babysitter inquired in the morning. Another staff disclosed was not present the day of incident but spoke with parent the following Tuesday when staff returned to work. Another staff disclosed parent was notified of injury verbally and in writing same day, as staff write incident reports in journal every day.

Based on the information provided to LPA by Reporting Party, three staff, Director, records reviewed and the inability to interview children due to school not being in session, there was insufficient evidence to determine if the allegation : staff did not notify authorized representative of day care child’s injuries is Substantiated. Based on confidential interviews with staff, and records reviewed . Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.
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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: 02/11/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2021

LIC9099 (FAS) - (06/04)

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Control Number 06-CC-20200313121824

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: SAUSD/DAVIS ELEM. SCHOOL-KINDER READINESS PROGRAM	FACILITY NUMBER: 304370547
	VISIT DATE: 02/11/2021

NARRATIVE

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Exit interview was conducted with Director Laura Barnett via Tele-Inspection. Report was read to Director. A copy of the report along with Appeal Rights will be emailed to Director with a Read Receipt to acknowledge report was received. If Read Receipt is not functional, Director 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: 02/11/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2021

LIC9099 (FAS) - (06/04)

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