304370606-9-12-2022-06-CC-THOO-CJEPFT-20220919111715

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 304370606
Report Date: 09/12/2022
Date Signed: 09/12/2022 12:29:54 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
07/27/2022 and conducted by Evaluator Tina Nguyen

PUBLIC

COMPLAINT CONTROL NUMBER: 06-CC-20220727134929

FACILITY NAME:	INDEPENDENCE CHRISTIAN PRESCHOOL		FACILITY NUMBER:	304370606
ADMINISTRATOR:	GASIMYAN, ADRINE		FACILITY TYPE:	850
ADDRESS:	4905 E LA PALMA AVENUE		TELEPHONE:	(714) 322-9246
CITY:	ANAHEIM	STATE: CA	ZIP CODE:	92807
CAPACITY:	78	CENSUS: 41	DATE:	09/12/2022
		UNANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	Adrine Gasimyan, Director		TIME COMPLETED:	12:00 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff are not adequately supervising day care children

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Tina Nguyen conducted an unannounced complaint visit to deliver the complaint findings. LPA met with director, Adrine Gasimyan. Census was taken in individual classrooms. The overall census observed was 5 preschool staff and 37 preschool children; 1 toddler teacher and 4 toddler children. A review of staff criminal clearance records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.
On 07/27/2022 a complaint was filed with the Licensing office stating the staff are not adequately supervising day care children. Complainants stated the following: facility staff members play on their phones and don’t pay attention to the children. Children were not adequately supervised during naptime and bathroom time.
On 08/01/2022, 08/10/2022, LPA Nguyen interviewed 5 staff members. Interviewed staff members denied of witnessing any staff playing on the phone and doesn’t pay attention to children.
Continue on page 2

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Tina Nguyen	TELEPHONE: (714) 292-2922
LICENSING EVALUATOR SIGNATURE:	DATE: 09/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2022

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-20220727134929

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: INDEPENDENCE CHRISTIAN PRESCHOOL	FACILITY NUMBER: 304370606
	VISIT DATE: 09/12/2022

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Page 2
Staff #2 and staff #4 indicated during naptime, if the children wanted to use the bathroom, the teacher would stand at the hallway to watch the children using the bathroom. While the teachers standing in the hallway to supervise the children using the bathroom, the teachers would constantly ask the children inside the bathroom if they’re ok or not to make sure the children were safe during the bathroom use. Staff #2 and staff #4 confirmed that if the teachers stood at the hallway, the teachers could not see the children inside the bathroom; During the inspection, LPA Nguyen stood at the hallway where the teachers stood to supervise the children using the bathroom, LPA Nguyen could not see what the children were doing inside the bathroom.
During the investigation, LPA Nguyen interviewed 4 children, no disclosures were made by any children. All interviewed children stated they have never witnessed their teachers playing on their phone and not supervising the children. The children also stated they like their teachers. LPA Nguyen contacted five parents by phone and was able to interview three parents. All interviewed parents stated they did not have any concern with facility.

Based on LPA’s interviews, information gathered, and observation, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 12, Chapter 1 Section 101229(a)(1) Responsibility for Providing Care and Supervision is being cited on the attached LIC 9099D. Please refer to attached 9099D for documentation of deficiencies.

An exit interview was completed. The report was reviewed and discussed. Appeal Rights and deficiencies were discussed. The facility representative was provided a copy of their appeal rights (LIC 9058 01/16) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Licensing office within 15 business days. Any proposed changes to the physical plant, including telephone number, shall be immediately reported to the Department.

The facility representative was informed that the “Notice of Site Visit” must be posted for 30 consecutive days. Failure to post will result in Civil Penalties of $100.00. The “Notice of Site Visit” must be posted on or adjacent to the door.
“Upon receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months.”

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Tina Nguyen	TELEPHONE: (714) 292-2922
LICENSING EVALUATOR SIGNATURE:	DATE: 09/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2022

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 06-CC-20220727134929

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: INDEPENDENCE CHRISTIAN PRESCHOOL	FACILITY NUMBER: 304370606
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/12/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 09/12/2022 Section Cited CCR 101229(a)(1)	1 2 3 4 5 6 7	101229 Responsibility for Providing Care and Supervision (a)The licensee shall provide care and supervision as necessary to meet the children's needs.(1)No child(ren) shall be left without the supervision of a teacher at any time, ... Supervision shall include visual observation. This requirement is not met as evidence by:	1 2 3 4 5 6 7	Director indicated that the facility started to have two staff members present during naptime, the staff members supervised the children at all time, including bathroom usage. Director indicated that she will email LPA Nguyen the written plan on how to supervise children during naptime and bathroom usage at the facility by 09/13/2022.
	8 9 10 11 12 13 14	Based on interviews and LPA’s observation, two staff members disclosed standing by the hallway to supervise the children inside the bathroom. From the hallway position, LPA Nguyen was unable to see what the children were doing inside the bathroom. This poses an immediate safety risk to the children in care.	8 9 10 11 12 13 14	The director planned to do a meeting with staff members on Providing Care and Supervision. Acknowledgement of Receipt Of Licensing Reports LIC 9224 dicussed with director. LPA Nguyen's email Tina.nguyen@dss.ca.gov
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Tina Nguyen	TELEPHONE: (714) 292-2922
LICENSING EVALUATOR SIGNATURE:	DATE: 09/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2022

LIC9099 (FAS) - (06/04)

Page: 3 of 3