304370987-10-13-2021-06-CC-JHAN-C7XPA3-20211019110804

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 304370987
Report Date: 10/13/2021
Date Signed: 10/13/2021 09:35:11 AM

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
08/16/2021 and conducted by Evaluator Carmen Odom

COMPLAINT CONTROL NUMBER: 06-CC-20210816163145

FACILITY NAME:	KIDDIE ACADEMY OF HUNTINGTON BEACH		FACILITY NUMBER:	304370987
ADMINISTRATOR:	CARREON, NICOLE		FACILITY TYPE:	850
ADDRESS:	19342 BEACH BLVD		TELEPHONE:	(714) 968-0078
CITY:	HUNTINGTON BEACH	STATE: CA	ZIP CODE:	92648
CAPACITY:	124	CENSUS: 28	DATE:	10/13/2021
		UNANNOUNCED	TIME BEGAN:	08:50 AM
MET WITH:	Amber Lopez - Assistant Director.		TIME COMPLETED:	09:40 AM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff do not wear masks properly

INVESTIGATION FINDINGS:

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

Licensing Program Analysts (LPA) Odom conducted an unannounced complaint investigation. This is a continuation of the investigation initiated on 08/17/2021. Upon arrival LPA met with Assistant Director, Amber Lopez, to deliver complaint findings. At 8:50 am Assistant Director guided LPAs on a tour of the facility. LPA took census, there were 28 preschool children and 8 staff; 5 children in older 2-year-old classroom with 1 staff, 9 children in the younger 2-year-old classroom with 2 staff, 5 children in 3-year-old classroom with 1 staff, 9 children in 4-year-old classroom with 2 staff and 0 children in 5-year-old classroom with 2 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.

Continue to page 2.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Judy Hanson	TELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Carmen Odom	TELEPHONE: (714) 703-2819
LICENSING EVALUATOR SIGNATURE:	DATE: 10/13/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/13/2021

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 4

Control Number 06-CC-20210816163145

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: 10/13/2021

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

The Department received a complaint on 8/16/2021 alleging staff do not wear masks properly. Complainant party (CP) stated Staff #1 (S1) and Staff #2 (S2) do not wear their face masks properly. CP stated they have observed that the staff wear their mask under the chin or under their nose. CP provided screen shot images.

During the investigation LPA Odom interviewed director, 2 Staff members, 7 parents, and reviewed children’s roster, personnel records, screen shot images, employee warning notices, COVID-19 school policies, and school text messages to parents/staff regarding masks.

During an interview on 8/17/21 and 9/29/21, Director (S3) stated COVID-19 school policies have been implemented at the childcare facility for staff and families. The childcare center enforces face mask on staff, all children over the age of 2 years old and family members who drop off and pick up. S3 provided a copy of weekly text message dated on 8/12/21 sent to all staff and families with the following statement, “Please make sure your face mask is covering your entire face at all times, inside and outside the classrooms.” S3 stated, on 8/12/21 a parent addressed the face mask concern, the situation was handled immediately by speaking with S1 and S2 and issuing an employee warning notice to S1 and S2. A reminder was sent to all staff to properly wear face masks in the childcare center at all times.

Two staff members were interviewed on 8/17/21. Both staff stated, the childcare center does enforce COVID-19 guidelines in the childcare center for staff and families. The childcare center has provided training on how to properly wear personal protective equipment (PPE). The childcare center enforces face mask wearing at the childcare center for staff, children and family members. S2 stated, sometimes I take my face mask off for an hour because it’s uncomfortable and the children cannot hear me.

Seven parents were interviewed on 9/15/21. All the parents stated, staff are always wearing face masks at the childcare center. The childcare facility does implement and enforce COVID-19 guidelines at the facility by wearing face mask, disinfecting, and taking temperatures upon entrance of the facility. The childcare center has provided COVID-19 polices and guidelines to families. None of the families had concerns with the childcare center.
Continue to page 3.

SUPERVISOR'S NAME: Judy Hanson	TELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Carmen Odom	TELEPHONE: (714) 703-2819
LICENSING EVALUATOR SIGNATURE:	DATE: 10/13/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/13/2021

LIC9099 (FAS) - (06/04)

Page: 2 of 4

Control Number 06-CC-20210816163145

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: 10/13/2021

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 3

Based on LPA’s facility inspection, observations, interviews conducted with complainant party, director, 2 staff, 7 parents, screen shots provided, and records reviewed, it has been determined that S1 and S2 were not wearing their face mask properly inside the classroom. Therefore, the preponderance of evidence standard has been met, therefore the above allegation is found to be Substantiated. California Code of Regulations, Title 22, 101223(a)(3) Personal Rights is being cited on the attached LIC 9099D.

Exit interview was conducted with Assistant Director, Amber Lopez. 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 Hanson	TELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Carmen Odom	TELEPHONE: (714) 703-2819
LICENSING EVALUATOR SIGNATURE:	DATE: 10/13/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/13/2021

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 06-CC-20210816163145

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: 10/13/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 10/13/2021 Section Cited CCR 101223(a)(3)	1 2 3 4 5 6 7	101223 Personal Rights (a) The licensee shall ensure that each child is accorded the following personal rights: (3) To be free of a... to: interference with functions of daily living including eating, sleeping or toileting; or withholding of shelter, clothing, medication or aids to physical functioning. This requirement was not met.	1 2 3 4 5 6 7	No further action needed. Director took action immediately by address the issue with S1 and S2.
	8 9 10 11 12 13 14	Based on interviews conducted, and pictures provided S1 and S2 were not wearing their face mask correctly while caring for children inside the classroom. This pose potential Health and Safety risk to 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: Judy Hanson	TELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Carmen Odom	TELEPHONE: (714) 703-2819
LICENSING EVALUATOR SIGNATURE:	DATE: 10/13/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/13/2021

LIC9099 (FAS) - (06/04)

Page: 4 of 4