304370988-11-25-2020-06-CC-JHAN-BW7U4U-20201211141545

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 304370988
Report Date: 11/23/2020
Date Signed: 11/25/2020 02:48:54 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
09/23/2020 and conducted by Evaluator Dean Valencia

PUBLIC

COMPLAINT CONTROL NUMBER: 06-CC-20200923131055

FACILITY NAME:	KIDDIE ACADEMY OF HUNTINGTON BEACH		FACILITY NUMBER:	304370988
ADMINISTRATOR:	CARREON, NICOLE		FACILITY TYPE:	840
ADDRESS:	19342 BEACH BLVD.		TELEPHONE:	(714) 968-0078
CITY:	HUNTINGTON BEACH	STATE: CA	ZIP CODE:	92648
CAPACITY:	22	CENSUS: 16	DATE:	11/23/2020
		UNANNOUNCED	TIME BEGAN:	03:31 PM
MET WITH:	Nicole Carreon, School director Amber Lopez, Assistant director		TIME COMPLETED:	04:15 PM

ALLEGATION(S):

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Facility is in disrepair, broken fence

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,parents, four children, and made two seperate physical tele inspections.

Based on information gathered from staff interviews, and parent’s interviews, as well as two seperate physical tele inspections, LPA was able to determine that the facility was not in compliance with physical plant regulations requirements. It was determined that for several months, a gate in the school age outdoor play area was broken, and unable to close and/or latch, allowing access to the preschool yard. The fence has been repaired as of September 2020. (continued on LIC9099C)

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Judy Hanson	TELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Dean Valencia	TELEPHONE: (714) 215-6737
LICENSING EVALUATOR SIGNATURE:	DATE: 11/23/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/23/2020

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

LIC9099 (FAS) - (06/04)

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Control Number 06-CC-20200923131055

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: 11/23/2020

NARRATIVE

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Therefore, the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 12, Chapter 3 Section 101238(a). Please refer to attached 9099D for documentation of deficiencies.

During the exit interview the facility representative was provided a copy of their appeal rights (LIC 9058 01/16) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Licensing office within 15 business days. If the facility receives a Type A violations, the licensee shall post and provide copies of the report to parents/guardians of the children in care at the facility by the next business day, and shall provide to the parents/guardians of children newly enrolled at the facility during the next 12 months. In addition, the licensee shall immediately post upon receipt the Proof of Correction for 30 consecutive days. Any proposed changes to the physical plant, including telephone number, shall be immediately reported to the Department.

SUPERVISOR'S NAME: Judy Hanson	TELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Dean Valencia	TELEPHONE: (714) 215-6737
LICENSING EVALUATOR SIGNATURE:	DATE: 11/23/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/23/2020

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 06-CC-20200923131055

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
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 11/23/2020

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 11/30/2020 Section Cited CCR 101228(a)	1 2 3 4 5 6 7	Buildings and Grounds 101238a) The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors.This was not met as evidenced by: LPA was able to determine that the facility was not in compliance with physical plant	1 2 3 4 5 6 7	The facility has since repaired the broken gate and the latch now works. Director has agreed to submit to LPA photo proof of the fixed gate/latch, email correspondance from the maintenance person confirming the fix, by 11/30/20.
	8 9 10 11 12 13 14	regulations requirements. It was determined that for several months, a gate in the school age outdoor play area was broken, and unable to close and/or latch, allowing access to the preschool yard. The fence has been repaired as of September 2020. This has posed a 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: Dean Valencia	TELEPHONE: (714) 215-6737
LICENSING EVALUATOR SIGNATURE:	DATE: 11/23/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/23/2020

LIC9099 (FAS) - (06/04)

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