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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304370880
Report Date: 02/14/2020
Date Signed: 02/14/2020 03:26:43 PM



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
12/12/2019 and conducted by Evaluator Sherene Hawkins
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20191212083100
FACILITY NAME:KIDDIE ACADEMY OF TUSTINFACILITY NUMBER:
304370880
ADMINISTRATOR:ESTRADA, ELAINAFACILITY TYPE:
830
ADDRESS:14501 NEWPORT AVENUETELEPHONE:
(714) 508-0005
CITY:TUSTINSTATE: CAZIP CODE:
92780
CAPACITY:36CENSUS: 30DATE:
02/14/2020
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Elaina Estrada TIME COMPLETED:
04:00 PM
ALLEGATION(S):
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Facility staff failed to provide a safe environment for the infants
Facility staff did not use appropriate napping equipment
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) S. Hawkins conducted a follow up investigation regarding a complaint of personal rights allegations which was initiated on 12/20/19. During today’s visit LPA provided the complaint findings to the Director Elena Estrada and assistant director Tina Trenner. LPA toured the center including all activity/classroom areas, and outdoor play areas. Upon arrival current census observed was 10 infant children with 3 staff in room 1, and 20 napping toddlers and 2 staff in room 2. A review of staff records on this date indicates that all facility staff or other individuals who required caregiver background checks have received criminal record and child abuse index clearances or exemptions.

The Department received a complaint alleging that facility staff failed to provide a safe environment for the infants, and staff did not use appropriate napping equipment. During the investigation, LPA interviewed 7 staff, 3 parents, and reviewed facility records regarding the above allegation.

Continued on page 2
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Sherene HawkinsTELEPHONE: (949) 466-1624
LICENSING EVALUATOR SIGNATURE:

DATE: 02/14/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2020
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 5
Control Number 06-CC-20191212083100
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: KIDDIE ACADEMY OF TUSTIN
FACILITY NUMBER: 304370880
VISIT DATE: 02/14/2020
NARRATIVE
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continued page 2

Staff reported that they were given approval by S6 to sleep infants on boppy pillows as long as someone was next to the infants providing supervision. Staff stated that they were aware of the safe sleep guidelines, however only used the boppy for napping if the infant was new and was having a hard time transitioning and sleeping in the crib. Staff reported that C1 and C2 is placed on the boppy for napping at times, and the time varies from 15 minutes to an hour the infants stay sleep. Staff also reports that boppy pillows are used with the infants during floor time activities when staff are engaged with the infants. LPA reviewed classroom video footage dated 12/12/19 of infant room 1. In the video LPA observed S5 supervising an infant positioned on its side on a boppy pillow, and after moments child eventually slipped down in the boppy pillow (face in between pillow). Staff was positioned next to child and after about 10 minutes staff did adjust child by turning infant upright on its back. It was also reported by a parent that four of the younger infants were observed sleeping on breast feeding pillows. Director and assistant reports that staff must be engaged in activities with infants if they are placed on boppy pillows, and do not allow staff to nap children on pillows. Director added that a parent did report concerns of how her child was observed to be napping (on a boppy pillow).



Based on LPA’s interviews conducted, and video records reviewed, the facility failed to ensure that each child is accorded the personal rights to have safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs which poses an immediate safety risk to the children in care. Facility also failed to provide the opportunity for infants to nap/sleep without distraction or disturbance from other activities at the center. This poses a potential safety risk to the children in care. Therefore, the preponderance of evidence standard has been met, therefore the above allegations of the facility staff failing to provide a safe environment for the infants, and staff not using appropriate napping equipment are found to be substantiated. California Code of Regulations, Title 22, Division 12 Section 101430(a)(3), and Section 101223(a)(2) are being cited on the attached LIC 9099D.

continued on page 3

SUPERVISOR'S NAME: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Sherene HawkinsTELEPHONE: (949) 466-1624
LICENSING EVALUATOR SIGNATURE:

DATE: 02/14/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2020
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 06-CC-20191212083100
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: KIDDIE ACADEMY OF TUSTIN
FACILITY NUMBER: 304370880
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/14/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/18/2020
Section Cited
CCR
101223(a)(2)
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101223(a)(2) Personal Rights. (a) The licensee shall ensure that each child is accorded the following personal rights:(2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs. The requirement is not met as evidence by:
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Per Director, all boppy pillows have been removed from the center, and director will conduct training in regards to safe sleeping for infants with all infant staff. Per assistant director, she will send a copy of the agenda with signature of staff attended by POC due date.
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Several staff acknowledged that C1 and C2 in room1 are placed on the boppy pillow for napping for approximately 15 minutes to 1 hour when they are having trouble sleeping. A parent also observed children napping on boppy pillows. This poses an immediate risk 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: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Sherene HawkinsTELEPHONE: (949) 466-1624
LICENSING EVALUATOR SIGNATURE:

DATE: 02/14/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2020
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 06-CC-20191212083100
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: KIDDIE ACADEMY OF TUSTIN
FACILITY NUMBER: 304370880
VISIT DATE: 02/14/2020
NARRATIVE
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continued page 3

This report cites a Type A violation and shall be provided to parents/guardians of children currently in enrolled and to parents/guardians of children newly enrolled at the facility during the next 12 months. Parents/guardians must sign Form LIC9224 to be kept in each child's file.

Exit interview was conducted with director and assistant director. Report was signed by assistant director. 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. All appeals must be in writing and received by the licensing office within 15 business days. The first level appeal is to regional manager.
SUPERVISOR'S NAME: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Sherene HawkinsTELEPHONE: (949) 466-1624
LICENSING EVALUATOR SIGNATURE:

DATE: 02/14/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2020
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 06-CC-20191212083100
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: KIDDIE ACADEMY OF TUSTIN
FACILITY NUMBER: 304370880
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/14/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/13/2020
Section Cited
CCR
101430(a)(3)
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101430 Infant Care Activities (a)(3) All infants shall be given the opportunity to nap/sleep without distraction or disturbance from other activities at the center whenever the infant desires. This requirement is not met as evidenced by:Based on 5 staff and parent interviews, and LPAs observation of video
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Per Director, all boppy pillows have been removed from the center, and director will conduct training in regards to safe sleeping for infants with all infant staff. Per assistant director, she will send a copy of the agenda with signature of staff attended by POC due date.
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 recording in room 1, while children are napping, staff failed to ensure infants were given the oppotunity to nap/sleep without distraction or disturbance from other activities while sleeping on boppy pillows away from the assigned napping area. This poses a potential Health and Safety risk to the 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: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Sherene HawkinsTELEPHONE: (949) 466-1624
LICENSING EVALUATOR SIGNATURE:

DATE: 02/14/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2020
LIC9099 (FAS) - (06/04)
Page: 5 of 5