304371171-3-28-2023-06-CC-PMAA-CQKMND-20230404094523

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 304371171
Report Date: 03/28/2023
Date Signed: 03/28/2023 10:38:40 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
01/24/2023 and conducted by Evaluator Cindy Nguyen

PUBLIC

COMPLAINT CONTROL NUMBER: 06-CC-20230124170122

FACILITY NAME:	VILLAGE PRESCHOOL ACADEMY		FACILITY NUMBER:	304371171
ADMINISTRATOR:	DIAZ, JOSEFINA		FACILITY TYPE:	830
ADDRESS:	18052 IMPERIAL HWY		TELEPHONE:	(714) 993-3444
CITY:	YORBA LINDA	STATE: CA	ZIP CODE:	92886
CAPACITY:	14	CENSUS: 7	DATE:	03/28/2023
		UNANNOUNCED	TIME BEGAN:	08:20 AM
MET WITH:	Assistant Director, Karen Villianueva-Diaz & Director, Josefina Diaz		TIME COMPLETED:	11:15 AM

ALLEGATION(S):

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Facility is not reporting outbreaks of contagious illnesses to the health department.
Facility is not notifying parents of an outbreak of hand foot and mouth disease.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Cindy Nguyen conducted an unannounced complaint investigation. This is a continuation of the investigation initiated on 01/30/2023. LPA met with the Assistant Director, Karen Villianueva-Diaz & Director, Josefina Diaz and informed the purpose of the investigation inspection. At 8:30am, census was taken as follow: 7 infant children with 3 staff members. A review of staff criminal records indicates all facility staff or individuals who require caregiver background checks have received a criminal record clearance or exemption and a child abuse index clearance.

On 1/24/2023 a complaint was filed with the Department alleging that facility is not reporting outbreaks of contagious illnesses to the health department and facility is not notifying parents of an outbreak of hand foot and mouth disease. During the investigation, LPA Nguyen conducted 2 physical plant inspection, interviewed complainant, 5 staff members, 6 parents, obtained and reviewed parent handbook, 6 children’s records and children's roster.
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Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Patricia Magana	TELEPHONE: (714) 743-5149
LICENSING EVALUATOR NAME: Cindy Nguyen	TELEPHONE: (714) 296-3608
LICENSING EVALUATOR SIGNATURE:	DATE: 03/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2023

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-20230124170122

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: VILLAGE PRESCHOOL ACADEMY	FACILITY NUMBER: 304371171
	VISIT DATE: 03/28/2023

NARRATIVE

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Complainant alleged that the facility didn’t report outbreaks of contagious illnesses such as hand foot mouth to the Health Department.

All staff interviewed denied any reporting of outbreak of Hand Foot and Mouth disease at the facility to the health department. Five staff interviewed stated that the facilities procedure is when a child is sick, the parents are asked to call the school’s office, if the child is at school and is sick, the teacher notifies the director immediately. Five staff interviewed stated that when the facility sends the child home for illness, a doctor’s note is needed upon return. The parent handbook policy states for communicable diseases, a notice will be posted for parent information and the facility will notify the Public Health Department within 24 hours should an occurrence of a “Reportable disease” occur. The director stated that if an incident report needs to be sent to Community Care Licensing or a notice to the parents, she will be the one completing the necessary form/s. Director stated a parent did express that a child was getting sick very often and we at the facility reinsured the parents that the facility is cleaning and sanitizing daily. Director also stated that one parent had mentioned back in September 2022 that a child had hand foot, and mouth disease. LPA interviewed Staff #5 who stated was made aware by parent that C #3 was diagnosed with Hand Foot and Mouth. Staff #5 stated that two other children were having symptoms but wasn’t aware if they were confirmed with Hand Food and Mouth disease. Staff #5 stated made the director aware of the one confirmed case and two other children with symptoms of the Hand Foot Mouth.

LPA called 11 parents, LPA was able to interview 6 parents out of 11 parents on 2/01/23, 3 out of the 6 parents disclosed that their children were infected with Hand Foot Mouth disease. On September 10, 2022, P7 stated C3 was diagnosed with Hand Foot Mouth disease. On September 12, 2022, P7 stated, reported to the school office and S5 C3’s diagnoses. On September 16, 2022, P4 stated C1 was diagnosed. On September 19, 2022, P4 reported to the director C1s diagnose. On September 19, 2022, P6 stated that C2 was diagnosed. On September 19, 2022, P6 stated reported to the school office and S5 on the same day.

On 3/28/23, LPA reviewed C1, C2, and C3 children’s records to determine the number of Hand Foot and Mouth disease reporting, LPA reviewed for incident reports, parent letters and medical notes.

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SUPERVISOR'S NAME: Patricia Magana	TELEPHONE: (714) 743-5149
LICENSING EVALUATOR NAME: Cindy Nguyen	TELEPHONE: (714) 296-3608
LICENSING EVALUATOR SIGNATURE:	DATE: 03/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 5

Control Number 06-CC-20230124170122

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: VILLAGE PRESCHOOL ACADEMY	FACILITY NUMBER: 304371171
	VISIT DATE: 03/28/2023

NARRATIVE

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Based on LPA interviews conducted with complainant, 5 staff members, 6 parents, and records reviewed by LPA, it has been determined that facility didn’t report outbreaks of contagious illnesses to the health department. The preponderance of evidence standard has been met; therefore, the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22 101212(d)(1)(E) Reporting Requirements is being cited on the attached LIC9099D.

Complainant also alleged that the facility is not notifying parents of an outbreak of hand foot and mouth disease.

All staff interviewed denied any reporting or outbreak of Hand Foot and Mouth disease at the facility to the parents. Five staff interviewed stated that the facilities procedure is when a child is sick, the parents are asked to call the school’s office, if the child is at school and is sick, the teacher notifies the director immediately. Five staff interviewed stated that when the facility sends the child home for illness, a doctor’s note is needed upon return. The parent handbook policy states for communicable diseases, a notice will be posted for parent information and the facility will notify the Public Health Department within 24 hours should an occurrence of a “Reportable disease” occur. The director stated that if an incident report needs to be sent to Community Care Licensing or a notice to the parents, she will be the one completing the necessary form/s. Director stated a parent did express that a child was getting sick very often and we at the facility reinsured the parents that the facility is cleaning and sanitizing daily. Director also stated that one parent had mentioned back in September 2022 that a child had hand foot, and mouth disease. LPA interviewed Staff #5 who stated was made aware by parent that C #3 was diagnosed with Hand Foot and Mouth. Staff #5 stated that two other children were having symptoms but wasn’t aware if they were confirmed with Hand Food and Mouth disease. Staff #5 stated made the director aware of the one confirmed case and two other children with symptoms of the Hand Foot Mouth.

LPA called 11 parents, LPA was able to interview 6 parents out of 11 parents on 2/01/23, 3 out of the 6 parents disclosed that their children were infected with Hand Foot Mouth disease. P4, P6 and P7 stated that the school did not disclose to them that the school had an outbreak of Hand Foot and Mouth disease.

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SUPERVISOR'S NAME: Patricia Magana	TELEPHONE: (714) 743-5149
LICENSING EVALUATOR NAME: Cindy Nguyen	TELEPHONE: (714) 296-3608
LICENSING EVALUATOR SIGNATURE:	DATE: 03/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2023

LIC9099 (FAS) - (06/04)

Page: 3 of 5

Control Number 06-CC-20230124170122

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: VILLAGE PRESCHOOL ACADEMY	FACILITY NUMBER: 304371171
	VISIT DATE: 03/28/2023

NARRATIVE

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Based on interviews conducted with staff and parents, it was determined that the facility did not report the contagious outbreak of Hand Foot Mouth disease to families. The preponderance of evidence standard has been met; therefore, the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22 101212(f) Reporting Requirements is being cited on the attached LIC9099D.

Exit interview was conducted with Assistant Director, Karen Villianueva-Diaz and Director Josefina Diaz. 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.

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SUPERVISOR'S NAME: Patricia Magana	TELEPHONE: (714) 743-5149
LICENSING EVALUATOR NAME: Cindy Nguyen	TELEPHONE: (714) 296-3608
LICENSING EVALUATOR SIGNATURE:	DATE: 03/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2023

LIC9099 (FAS) - (06/04)

Page: 4 of 5

Control Number 06-CC-20230124170122

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: VILLAGE PRESCHOOL ACADEMY	FACILITY NUMBER: 304371171
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/28/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 04/04/2023 Section Cited CCR 101212(d)(1)(E)	1 2 3 4 5 6 7	101212 Reporting Requirements (d) Upon the occurrence..., a report shall be made to the Dept by telephone... next working day and during its normal business hours.... (d)(2) below shall be submitted to the Dept within seven days... (1) Events reported... (E) Epidemic outbreaks. This is a potential Health and Safety risk to the children in care.	1 2 3 4 5 6 7	Director stated they will make sure they report any outbreaks of 2 or more cases within 24 hours via phone call and submit a written incident report within 7 days. Director will submit LIC624 Unusual incident report for the last outbreak by 04/04/23.
	8 9 10 11 12 13 14	Based on interviews conducted by LPA, it was determined that the facility did not report the contagious outbreak of Hand Foot Mouth disease to families, licensing, and department of public health. This is a potential Health and Safety risk to the children in care.	8 9 10 11 12 13 14
Type B 04/04/2023 Section Cited CCR 101212(f)	1 2 3 4 5 6 7	101212 Reporting Requirements (f) The items specified in (d)(1)(A) through (H) above shall also be reported to the child's authorized representative. This requirement is not met as evidenced by:	1 2 3 4 5 6 7	The director will conduct a meeting with all staff regarding the reporting requirements and cover the incident reports to be provided to the authorized representatives. The Director will provide the staff meeting agenda by 04/04/2023.
	8 9 10 11 12 13 14	Based on interviews conducted with staff and parents, it was determined that the facility did not report the contagious outbreak of Hand Foot Mouth disease to families. This is a potential Health and Safety risk to the children in care	8 9 10 11 12 13 14

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: Patricia Magana	TELEPHONE: (714) 743-5149
LICENSING EVALUATOR NAME: Cindy Nguyen	TELEPHONE: (714) 296-3608
LICENSING EVALUATOR SIGNATURE:	DATE: 03/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2023

LIC9099 (FAS) - (06/04)

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