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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304370987
Report Date: 08/09/2022
Date Signed: 08/09/2022 10:29:24 AM

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
06/27/2022 and conducted by Evaluator Carmen Odom
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20220627102847
FACILITY NAME:KIDDIE ACADEMY OF HUNTINGTON BEACHFACILITY NUMBER:
304370987
ADMINISTRATOR:CARREON, NICOLEFACILITY TYPE:
850
ADDRESS:19342 BEACH BLVDTELEPHONE:
(714) 968-0078
CITY:HUNTINGTON BEACHSTATE: CAZIP CODE:
92648
CAPACITY:124CENSUS: 50DATE:
08/09/2022
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Nicole Carreon - DirectorTIME COMPLETED:
11:00 AM
ALLEGATION(S):
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Staff did not properly supervise day care children.
Daycare child sustained injuries while in care.
Childcare did not report incident.
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPA) Odom conducted an unannounced complaint investigation. This is a continuation of the investigation initiated on 7/5/2022. Upon arrival LPA met with Director, Nicole Carreon, to deliver complaint findings. Director guided LPA on a tour of the facility. LPA took census, there were a total of 50 preschool children and 7 staff.

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.

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Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Carmen OdomTELEPHONE: (714) 703-2819
LICENSING EVALUATOR SIGNATURE:

DATE: 08/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2022
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 5
Control Number 06-CC-20220627102847
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 HUNTINGTON BEACH
FACILITY NUMBER: 304370987
VISIT DATE: 08/09/2022
NARRATIVE
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The Department received a complaint on 6/27/2022 alleging staff did not properly supervised day care children, and daycare child sustained injuries while in care. The complainant party (CP) stated on 6/24/22 CP observed child #1 (C1) had a bit mark on the right hand, when CP questioned the staff regarding the bite mark staff could not provide details of the incident. CP stated later that day CP observed C1 had another bit mark on the left leg. The CP stated to LPA that the childcare facility did not report either incident to CP on 6/24/22, the day they occurred.

During the investigation LPA Odom interviewed complaining party, director, 4 staff members, and 5 parents. LPA reviewed the Children’s Roster, personnel records, and biting report. Children did not qualify for interviews. Video recording was not available due to cameras not currently working.

During an interview on 7/5/2022, the Director (S1) stated they were not at the facility on the day of incident (6/24/22). On 6/27/22 S1 spoke with CP regarding the incident and CP also spoke with Staff #2 (S2) and Staff #3 (S3) that were caring for the children on 6/24/22. S1 disclosed according to S2 statement and biting reports they believe C1 was bit once outside in the playground and the second time during an emergency evacuation drill. On 6/27/22 Staff #5 (S5) gave CP the bite report regarding both incidents that S2 and S3 wrote. S1 stated on 6/28/22 they went over the supervision policies with all the staff and each staff signed the supervision policy. They have also created supervision zones where staff are supposed to rotate and observe all areas while outdoors.

LPA Odom interviewed four staff members on 7/5/22. Staff #2 (S2) stated, on 6/24/22 there was an emergency evacuation drill around 10:30am, in which, all the children were gathered and headed outside to the playground area. During a emergency evacuation drill each classroom is supposed to line up and sit in a line, but a few of the children thought it was time for outdoor play, so they had to chase a couple of the children and redirect them back to the line. S2 stated while they were chasing children that’s when C1 was bit by another 2-year-old from the other classroom that was sitting next to their class during the emergency evacuation drill. S2 stated they never heard C1 cry that day. S2 stated C1 is nonverbal and will express their pain or emotions by crying.

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SUPERVISOR'S NAME: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Carmen OdomTELEPHONE: (714) 703-2819
LICENSING EVALUATOR SIGNATURE:

DATE: 08/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 06-CC-20220627102847
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 HUNTINGTON BEACH
FACILITY NUMBER: 304370987
VISIT DATE: 08/09/2022
NARRATIVE
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S2 stated they never observed any bite marks on C1 until around 4:00pm when Staff #4 (S4) was changing C1’s diaper and S4 questioned S2 regarding a red mark on C1’s leg, the mark was a red circle, but it did not look like a bite mark. Staff #3 stated C1 had a good day that day they never heard C1 cry or observed another child biting C1. S4 disclosed they did not provide an incident report to CP on 6/24/22 during pick up because they didn’t observe another child biting C1 and was not aware of the bite marks on C1. All of the staff disclosed S1 went over supervision policies with them and they are practicing supervision zones.

LPA Odom attempted to interview 12 parents; however, 5 parents were available for interviews on 7/28/22, and 8/4/22. All the parents interviewed stated the children are always supervised by staff and the childcare center will notify parents immediately if their child sustains an injury. All the parents are satisfied with the childcare center and didn’t express any concern regarding supervision.

Based on LPA’s facility inspection, observations, interviews conducted with complainant party, director, 4 staff members, 5 parents, and records reviewed, it has been determined that staff did not properly supervise C1 while in care, and C1 sustained injuries while in care. Therefore, the preponderance of evidence standard has been met, therefore the above allegation is found to be Substantiated. California Code of Regulations, Title 22, 101229(a) and 101226(a)(2) is being cited on the attached LIC 9099D.

LPA Odom informed Director that this report dated 8/9/2022 documents 1 Type A citations which shall be posted for 30 consecutive days as there are immediate risks to the health, safety, or personal rights of children in care. Also, LPA Odom informed the Director to provide a copy of this licensing report dated 8/9/2022 that documents any Type A citations to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

Exit interview was conducted with Director Nicole Carreon. Notice of Site Visit was posted during the visit. Director 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. Director 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: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Carmen OdomTELEPHONE: (714) 703-2819
LICENSING EVALUATOR SIGNATURE:

DATE: 08/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 06-CC-20220627102847
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 HUNTINGTON BEACH
FACILITY NUMBER: 304370987
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/09/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/09/2022
Section Cited
CCR
101229(a)
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101229 Responsibility for Providing Care and Supervision (a) The licensee shall provide care and supervision as necessary to meet the children's needs. This requirement is not met as evidenced by:
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Director stated they went over supervision policies with all staff on 6/28/22 and each staff signed the supervision policy. They have also implemented supervision zones in the outdoor playground. Director stated they will provide a written statement with supervision POC by 8/10/22.
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Based on interviews from Staff #2 and Staff #3, they did not observe when C1 was bit on the right arm and left leg by another child. They believe it happened outside in the playground and during the fire drill, but they disclosed they did not observe when the incident occurred. This is 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: Carmen OdomTELEPHONE: (714) 703-2819
LICENSING EVALUATOR SIGNATURE:

DATE: 08/09/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2022
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 06-CC-20220627102847
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 HUNTINGTON BEACH
FACILITY NUMBER: 304370987
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/09/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/09/2022
Section Cited
CCR
101226(a)(2)
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101226 Health-Related Services
(a) The licensee shall immediately notify... (2)...less serious injuries including,... and bites... notify the child's authorized representative of the nature of the injury when the child is picked up from the center. This requirement is not met as evidenced by:
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Director stated they will provide a written POC on reporting requirement when a child sustains an injury. A biting report was provided to CP on 6/27/22 regarding the incident of C1.
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Based on interviews with director, staff #5 and biting report CP was not informed of the incident on 6/24/22 and the biting report was not given to CP until 6/27/22. This is a potential risk to the health and safety of 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: Carmen OdomTELEPHONE: (714) 703-2819
LICENSING EVALUATOR SIGNATURE:

DATE: 08/09/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2022
LIC9099 (FAS) - (06/04)
Page: 5 of 5