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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304370988
Report Date: 11/25/2020
Date Signed: 11/25/2020 02:49:17 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
09/22/2020 and conducted by Evaluator Dean Valencia
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20200922151855
FACILITY NAME:KIDDIE ACADEMY OF HUNTINGTON BEACHFACILITY NUMBER:
304370988
ADMINISTRATOR:CARREON, NICOLEFACILITY TYPE:
840
ADDRESS:19342 BEACH BLVD.TELEPHONE:
(714) 968-0078
CITY:HUNTINGTON BEACHSTATE: CAZIP CODE:
92648
CAPACITY:22CENSUS: 5DATE:
11/25/2020
UNANNOUNCEDTIME BEGAN:
11:01 AM
MET WITH:Director and Infant DirectorTIME COMPLETED:
12:30 PM
ALLEGATION(S):
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Lack of supervision resulting in day care child sustaining an injury while in care.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Dean Valencia conducted an unannounced complaint tele-inspection on today's date. LPA met with director and infant director who guided analyst on a tour of the facility and census of children was taken. 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. During the course of the investigation, LPAs interviewed five staff members, four children, parents, and made two seperate physical tele inspections.

Based on LPA's observations and interviews the preponderance of evidence standard was not met, therefore the above allegation is found to be unsubstantiated. It has been determined that from all of the available information obtained by LPA during the course of the investigation, that there is insufficient evidence indicating that staff violated supervision regulation related to this allegation. (continued on LIC9099C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Dean ValenciaTELEPHONE: (714) 215-6737
LICENSING EVALUATOR SIGNATURE:

DATE: 11/25/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/25/2020
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 2
Control Number 06-CC-20200922151855
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: 304370988
VISIT DATE: 11/25/2020
NARRATIVE
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From the investigation conducted by LPA Valencia, there is not a preponderance of evidence to support this allegation. This allegation could not be proven; although the LPA was unable to obtain any information during the investigation demonstrating that the allegation were definitively false, nor proven to be unfounded.

Exit interview was conducted. The report was reviewed and discussed. Appeal Rights were discussed. The facility representative was provided a copy of their appeal rights (LIC 9058 12/15) and their signature on this form acknowledges receipt of these rights.
SUPERVISOR'S NAME: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Dean ValenciaTELEPHONE: (714) 215-6737
LICENSING EVALUATOR SIGNATURE:

DATE: 11/25/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/25/2020
LIC9099 (FAS) - (06/04)
Page: 2 of 2