304370917-9-3-2019-06-CC-RLOZ-BFY4MA-20190912191312

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 304370917
Report Date: 09/03/2019
Date Signed: 09/03/2019 08:00:27 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
08/13/2019 and conducted by Evaluator Stacy Torrence

PUBLIC

COMPLAINT CONTROL NUMBER: 06-CC-20190813165052

FACILITY NAME:	BOUSD-MARIPOSA EARLY LEARNING CENTER		FACILITY NUMBER:	304370917
ADMINISTRATOR:	CORDOVA-PEREZ, ANGELICA		FACILITY TYPE:	850
ADDRESS:	1111 WEST MARIPOSA DRIVE		TELEPHONE:	(714) 990-7536
CITY:	BREA	STATE: CA	ZIP CODE:	92821
CAPACITY:	24	CENSUS: 13	DATE:	09/03/2019
		UNANNOUNCED	TIME BEGAN:	03:35 PM
MET WITH:	Meredith White		TIME COMPLETED:	05:40 PM

ALLEGATION(S):

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Facility is operating beyond the scope of the license

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Torrence conducted an unannounced complaint inspection on 09/03/2019 to follow up on the complaint investigation that was conducted on 08/22/2019. LPA met with Meredith White, Supervisor who guided analyst on a tour of the Early Childhood Setting. There were 13 children present with two staffs supervising. During today’s investigation the facility was operating within its licensed capacity and within compliance of staffing ratios. 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.

Allegation: Facility is operating beyond the scope of the license. The Complainant reported in July 2019 the facility had 25 children. After interviewing the complainant, it was disclosed that the exact date the facility had 25 children, was uncertain. During the inspection conducted on 08/22/2019, LPA Torrence obtained a copy of the children’s sign in/out sheets for the month of July. After reviewing the children’s sign in/out sheets, LPA discovered that on 07/24/2019, 25 children were signed in/out. During today’s inspection, LPA discussed the allegation with Supervisor Meredith White, and she disclosed that the facility did have 25 children on 07/24/2019.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Stacy Torrence	TELEPHONE: (714) 300-3599
LICENSING EVALUATOR SIGNATURE:	DATE: 09/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2019

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

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
08/13/2019 and conducted by Evaluator Stacy Torrence

PUBLIC

COMPLAINT CONTROL NUMBER: 06-CC-20190813165052

FACILITY NAME:	BOUSD-MARIPOSA EARLY LEARNING CENTER		FACILITY NUMBER:	304370917
ADMINISTRATOR:	CORDOVA-PEREZ, ANGELICA		FACILITY TYPE:	850
ADDRESS:	1111 WEST MARIPOSA DRIVE		TELEPHONE:	(714) 990-7536
CITY:	BREA	STATE: CA	ZIP CODE:	92821
CAPACITY:	24	CENSUS: 13	DATE:	09/03/2019
		UNANNOUNCED	TIME BEGAN:	03:35 PM
MET WITH:	Meredith White		TIME COMPLETED:	05:40 PM

ALLEGATION(S):

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Facility staff did not offer children a nap

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Torrence conducted an unannounced complaint inspection on 09/03/2019 to follow up on the complaint investigation that was conducted on 08/22/2019. LPA met with Meredith White, Supervisor who guided analyst on a tour of the Early Childhood Setting. There were 13 children present with two staffs supervising. During today’s investigation the facility was operating within its licensed capacity and within compliance of staffing ratios. 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.

Allegation: Facility staff did not offer children a nap. Complainant reported that on July 2019 the classroom did not have enough beds for the children, resulting in one child not offered a nap. Complainant reported they had 24 beds/cots. Complainant reported that the facility had extra beds/cots but did not use them that day. Staff stated that they have enough mats for all the children in care. During the inspection on 08/22/2019, LPA Torrence observed 26 children's mats, in the closet.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Stacy Torrence	TELEPHONE: (714) 300-3599
LICENSING EVALUATOR SIGNATURE:	DATE: 09/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2019

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 3 of 5

Control Number 06-CC-20190813165052

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: BOUSD-MARIPOSA EARLY LEARNING CENTER	FACILITY NUMBER: 304370917
	VISIT DATE: 09/03/2019

NARRATIVE

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Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated.

Exit interview was conducted. The report was reviewed and discussed. 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. Failure to post Type A reports for 30 days will result in a Civil Penalty of $100.00.

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Stacy Torrence	TELEPHONE: (714) 300-3599
LICENSING EVALUATOR SIGNATURE:	DATE: 09/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2019

LIC9099 (FAS) - (06/04)

Page: 4 of 5

Control Number 06-CC-20190813165052

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: BOUSD-MARIPOSA EARLY LEARNING CENTER	FACILITY NUMBER: 304370917
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/03/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 09/04/2019 Section Cited CCR 101161(a)	1 2 3 4 5 6 7	101161(a) Limitations on Capacity and Ambulatory Status. A licensee shall not operate a child care center beyond the conditions and limitations specified on the license, including the capacity limitation. The requirement is not met as evidence by record of children’s sign in/out sheet for 07/24/2019	1 2 3 4 5 6 7	Per Supervisor, there will be a site coordinator connect meeting discussing the facility's license limitations. Per Director, she will send LPA a copy of the agenda with staff signatures by POC due date.
	8 9 10 11 12 13 14	and it was discovered that 25 children were signed in on that date. This poses a potential risk to the safety of children in care.	8 9 10 11 12 13 14
	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: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Stacy Torrence	TELEPHONE: (714) 300-3599
LICENSING EVALUATOR SIGNATURE:	DATE: 09/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2019

LIC9099 (FAS) - (06/04)

Page: 5 of 5

Control Number 06-CC-20190813165052

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: BOUSD-MARIPOSA EARLY LEARNING CENTER	FACILITY NUMBER: 304370917
	VISIT DATE: 09/03/2019

NARRATIVE

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Based on interviews and review of the children’s sign in/out sheets, the preponderance of evidence standard has been met; therefore, the 101161(a) Limitations on Capacity and Ambulatory Status allegation is found to be substantiated. California Code of Regulations, Title 22, Division 12 & Chapter 1, is being cited on the attached LIC 9099D.

Exit interview was conducted. The report was reviewed and discussed. 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. Failure to post Type A reports for 30 days will result in a Civil Penalty of $100.00.

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Stacy Torrence	TELEPHONE: (714) 300-3599
LICENSING EVALUATOR SIGNATURE:	DATE: 09/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2019

LIC9099 (FAS) - (06/04)

Page: 2 of 5