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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304370702
Report Date: 11/04/2019
Date Signed: 11/14/2019 04:18:39 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:SUNFLOWER PRESCHOOL & KINDERGARTENFACILITY NUMBER:
304370702
ADMINISTRATOR:GARDUNO, MICHELLEFACILITY TYPE:
850
ADDRESS:2129 W EDINGERTELEPHONE:
(714) 979-7422
CITY:SANTA ANASTATE: CAZIP CODE:
92704
CAPACITY:59CENSUS: 38DATE:
11/04/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:51 AM
MET WITH:Director Michelle GardunoTIME COMPLETED:
04:15 PM
NARRATIVE
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An unannounced case management report was initiated on this date by Licensing Program Analyst (LPA’s) Barajas and Nelson based on information discovered during an inspection for an unrelated complaint investigation on 08/28/19.

Present today was Director Michelle Garduno, who greeted LPA upon arrival. During Facility Inspection LPA observed 10 children outside in playground with 1 staff, 18 children in room 5# with Two Staff and 10 children with 1 staff in room 1.

Based on LPA Barajas visual observation during facility records review on 08/28/19, it was discovered a that an unusual incident was not reported for inappropriate touching over the child’s clothes to the department. LPA Barajas observed an incident report dated 08/26/19 in records reviewed. LPA obtained documents from a third-party agency, that states day care facility reported information on a later date beyond the 24-hour mandated. Incident occurred on 08/26/19 and third-party collateral agency referral is dated 09/09/19. LPA took picture of incident report. Interviews were conducted with Two Staff, children not interviewed therefore facility will be cited for Mandated Reporting Requirements.

Mandated Reporter Training, Health and Safety Section: 1596.8662(b)(1) is being cited on the attached LIC 809D.

Exit interview was conducted. Notice of Site Visit was posted during the visit. Licensee 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. Licensee was provided a copy of their appeal rights (LIC 9058 01/16) and their signature on this form acknowledges receipt of these rights. First level appeals should be sent to the regional manager to the address listed above

SUPERVISOR'S NAME: Patricia MaganaTELEPHONE: (714) 743-5149
LICENSING EVALUATOR NAME: Leonor BarajasTELEPHONE: (714) 292-8628
LICENSING EVALUATOR SIGNATURE:

DATE: 11/04/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION 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: SUNFLOWER PRESCHOOL & KINDERGARTEN
FACILITY NUMBER: 304370702
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/04/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/08/2019
Section Cited

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1596.8662(B) Reporting requirements for child abuse and neglect, including guidelines on how to make a suspected child abuse report when suspected abuse or neglect takes place ...within a child day care facility, and to which enforcement agency or agencies a report is required to be made. This requirement was not met as evidenced by:
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Based on records reviewed and interviews conducted with two staff who stated unusual incident occured on 08/26/19 and did not report incident to third party agency until 09/09/19. This poses a potential immediate threat to the health and safety of 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: Patricia MaganaTELEPHONE: (714) 743-5149
LICENSING EVALUATOR NAME: Leonor BarajasTELEPHONE: (714) 292-8628
LICENSING EVALUATOR SIGNATURE:
DATE: 11/04/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/04/2019
LIC809 (FAS) - (06/04)
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