304371094-9-11-2019-06-CC-LBAS-BFWT7Q-20190911142909

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304371094
Report Date: 09/11/2019
Date Signed: 09/11/2019 02:29:19 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME:	KIDDIE LEARNING ACADEMY		FACILITY NUMBER:	304371094
ADMINISTRATOR:	WYATT, JENNA		FACILITY TYPE:	830
ADDRESS:	3516 W. COMMONWEALTH AVENUE		TELEPHONE:	(714) 680-0567
CITY:	FULLERTON	STATE: CA	ZIP CODE:	92833
CAPACITY:	8	CENSUS: 8	DATE:	09/11/2019
TYPE OF VISIT:	Case Management - Deficiencies	UNANNOUNCED	TIME BEGAN:	12:15 PM
MET WITH:	Director Jenna Wyatt		TIME COMPLETED:	01:00 PM

NARRATIVE

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An unannounced case management report was initiated on this date by Licensing Program Analyst (LPA), Barajas based on information discovered during an inspection for an unrelated complaint investigation on 08/14/19. During today's inspection there were 8 infants and 2 infant staff members present in infant room.

Based on LPA Barajas visual observation during facility inspection walk through on 08/14/19, it was discovered a staff was alone in infant room with 8 napping infants. LPA Barajas observed 1 staff alone on the floor calming two infants who were awake laying on cots with 4 other infants who were sleeping. LPA then inspected the crib area which was 10-12 ft away from staff who was on the floor. LPA observed an open red door and a wall approximately 4ft tall, the wall visually obstructed the view of the staff who was on the floor from visually observing infant sleeping in crib that was horizontal to the wall. The infant was sleeping on its stomach. There were two infants in crib area, the other crib was positioned vertically, infant was sleeping on his side, and from staff view, staff could only observe top of head through crib clear glass, no staff were in crib area visually supervising the napping infant. LPA took pictures of infant and crib area. California Code of Regulations, Title 22, Division 12, Section 101429(a)(1) Responsibility for Providing Care and Supervision for Infants is being cited on the attached LIC 809D.

This report cites a Type A violation and shall be provided to parents/guardians of children currently in enrolled and to parents/guardians of children newly enrolled at the facility during the next 12 months. Parents/guardians must sign Form LIC9224 to be kept in each child's file.

Exit interview was conducted. Notice of Site Visit was posted during the visit. Licensee 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. Licensee 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: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Leonor Barajas	TELEPHONE: (714) 703-2825
LICENSING EVALUATOR SIGNATURE:	DATE: 09/11/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2019

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

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION 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 LEARNING ACADEMY	FACILITY NUMBER: 304371094
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/11/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Request Denied Type A 09/12/2019 Section Cited	1 2 3 4 5 6 7	101429(a)(1) Responsibility for Providing Care and Supervision for Infants-In addition to Section 101229, the following shall apply:(1) Each infant shall be constantly supervised and under direct visual... Under no circumstances shall ANY infant be left unattended. This requirement is not met as evidenced by:
	8 9 10 11 12 13 14	Based on observation during facility inspection, LPA Barajas observed 2 infants sleeping separately in a crib, in crib room. Staff was alone and did not have visual supervision and a 4ft wall was obstructing view. This poses an immediate risk to the health and 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

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: Leonor Barajas	TELEPHONE: (714) 703-2825
LICENSING EVALUATOR SIGNATURE:	DATE: 09/11/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2019

LIC809 (FAS) - (06/04)

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