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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304370580
Report Date: 05/28/2021
Date Signed: 05/28/2021 02:40:47 PM

Substantiated


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
03/04/2021 and conducted by Evaluator Jordann Nelson
COMPLAINT CONTROL NUMBER: 06-CC-20210304102059
FACILITY NAME:APPLE TREE LEARNING ACADEMYFACILITY NUMBER:
304370580
ADMINISTRATOR:SUK, JUNG H.FACILITY TYPE:
850
ADDRESS:2338 EAST WAGNER AVENUETELEPHONE:
(714) 284-0706
CITY:ANAHEIMSTATE: CAZIP CODE:
92806
CAPACITY:48CENSUS: 25DATE:
05/28/2021
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Suk JungTIME COMPLETED:
12:00 PM
ALLEGATION(S):
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Staff inappropriately handled day care child.
INVESTIGATION FINDINGS:
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On 05/28/2021 Licensing Program Analyst (LPA) Jordann Nelson conducted an announced complaint visit regarding the allegation listed above with Director Suk Jung

A review of the Facility Personnel Summary on the above date indicates that all staff have criminal background clearance check clearances and are properly associated to the center.On 03/042021
a complaint was filed with the Department that a staff inappropriately handled a day care child.


During the investigation, LPA Nelson observed at the daycare center during normal operating hours. The preschool classroom was observed. The director, three teachers and five parents and five children were interviewed.

continued on page 2
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Jordann Nelson
LICENSING EVALUATOR SIGNATURE:

DATE: 05/28/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/28/2021
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 3
Control Number 06-CC-20210304102059
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: APPLE TREE LEARNING ACADEMY
FACILITY NUMBER: 304370580
VISIT DATE: 05/28/2021
NARRATIVE
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continued from page 1

Interviews were conducted with the director who stated that a former teacher that in order to help the child in question focus the former teacher placed hands on the top of the child in question hair and head so that they would focus on the task at hand. The former teacher was interviewed confirming that she did place her hand on top of the child head to focus direct the child in question on a class activity one time. Interviews were conducted with parent and child in question confirming that that former teacher did place their hands on the head of the child in question without the child permission, during a class activity. The teacher did not “squish” the child in question head.

Interviews were conducted with two other teachers, four parents and four children who did not witness or experience any hands on by the former teacher.

Based on interviews conducted with the director and the former teacher the staff did inappropriately handle the day care child Title 22, Division 12, 101223 (a)(3) Personal Rights is being cited on the attached LIC 9099D.

Exit interview was conducted with Suk Jung Report was read to Director. A copy of the report along with Appeal Rights were read to the director. All appeals must be in writing and received by the Licensing office within 15 business days. End of report.

SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Jordann Nelson
LICENSING EVALUATOR SIGNATURE:

DATE: 05/28/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/28/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 06-CC-20210304102059
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: APPLE TREE LEARNING ACADEMY
FACILITY NUMBER: 304370580
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/28/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/28/2021
Section Cited
CCR
101223(a)(3)
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Personal Rights The licensee shall ensure that each child is accorded the following personal rights: To be free from corporal or unusual punishment, infliction of pain...

This requirement was not met as evidence by:
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The licensee will conduct a traninig ensuring that the staff are trainied in personal rights with how they interact with the children.
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Based on interviews and information gathered during the complaint investigation. The teacher placed her hands on a child head while refoucsing them on a class activity and was a violation of the the childs personal rights.
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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.
SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Jordann Nelson
LICENSING EVALUATOR SIGNATURE:

DATE: 05/28/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/28/2021
LIC9099 (FAS) - (06/04)
Page: 3 of 3