304371505-7-8-2022-06-CC-PMAA-CGCR4E-20220715124124

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 304371505
Report Date: 07/08/2022
Date Signed: 07/08/2022 11:03:51 AM

Unsubstantiated

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
04/20/2022 and conducted by Evaluator Alanna Gontarek

PUBLIC

COMPLAINT CONTROL NUMBER: 06-CC-20220420084845

FACILITY NAME:	KIDDIE ACADEMY OF COSTA MESA		FACILITY NUMBER:	304371505
ADMINISTRATOR:	HAIKAL, JOSEPH		FACILITY TYPE:	830
ADDRESS:	1815 ANAHEIM AVENUE		TELEPHONE:	(949) 402-3288
CITY:	COSTA MESA	STATE: CA	ZIP CODE:	92627
CAPACITY:	19	CENSUS: 10	DATE:	07/08/2022
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Tina Trenner		TIME COMPLETED:	10:30 AM

ALLEGATION(S):

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Staff are force feeding day care child
Staff are not properly documenting day care child's feeding

INVESTIGATION FINDINGS:

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On 7/8/2022, an unannounced follow up complaint inspection was made on this day by Licensing Program Analyst (LPA) Alanna Gontarek to the licensed Child Care Center, Kiddie Academy of Costa Mesa. LPA met with Director, Tina Trenner to discuss the above allegations. At the time of arrival LPA observed 10 infants with 4 staff. During the inspection, it was determined the facility is operating within its licensed capacity and within compliance of staffing ratios.
A review of staff criminal clearance 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. Facility representative was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.
Investigation was conducted and completed by LPA Alanna Gontarek. LPA conducted interviews with complainant, 5 staff, and 6 children’s authorized representatives. Children were unable to be interviewed due to

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Alanna Gontarek
LICENSING EVALUATOR SIGNATURE:	DATE: 07/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2022

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-20220420084845

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 COSTA MESA	FACILITY NUMBER: 304371505
	VISIT DATE: 07/08/2022

NARRATIVE

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age and being non-verbal (infants). Documents obtained and reviewed were as follows: Roster, Tadpole Daily Reports for C1 from 3/8/22 to 4/14/22, Infant Room Standard Operating Procedures, Parent Handbook, Diet Restriction Letter for C1, and C1’s Infant schedule completed on 3/10/22.
Per complainant, alleges on 4/14/22, around 2:00 p.m., Staff #4 (S4) force fed Child #1 (C1) with a spoon, while feeding C1 pureed baby food, causing child to cry, staff continued force feeding C1. During interview conducted with complainant, complainant stated C1 is given solid foods at home, and C1 has no trouble eating solids provided. Complainant stated that staff were aware of C1 trying new solid foods, and complainant provided all foods to the daycare for C1 to eat. Complainant also alleges facility staff did not document accurate amounts of food given to C1, in facility’s Tadpole application.
Pertaining to the allegation: Staff are force feeding daycare child. During interviews conducted with staff, S4 stated that on 4/14/22, C1 ‘s authorized representative brought in a new pureed solid food for C1 to try. S4 stated that a verbal authorization by C1’s parent was given to introduce and feed, a new pureed food to C1. S4 went ahead and fed C1, C1’s food brought from home. S4 also stated C1 was only drinking bottled formula prior to this new pureed food. S4 stated that on 4/14/22, C1 was “fussing” prior to C1’s feeding. S4 began feeding C1 a little bit of the pureed food brought from C1’s home, with a spoon, and C1 began gagging. S4 stated she noticed chunks in the pureed food, so S4 stirred pureed food to make it mushier, and tried to feed C1 for a second time. Per S4, C1 began to gag again, and S4 stopped feeding C1 the pureed food and proceeded to give C1 a premade bottle brought from C1’s home. S2 stated that C1 was having difficulty swallowing C1’s pureed food brought from home, and S2 called C1’s authorized representative to inform of C1’s difficulty with the food. During interview with staff, S1 and S2, both staff stated they observed the video footage of the incident on 4/14/22, C1 was observed choking on the pureed solid food, not the spoon. During interviews conducted with staff, 5 out of 5 staff stated premade bottles and infant food are provided by children’s authorized representatives. All staff interviewed denied allegation of S4 force feeding C1 with spoon.
During interviews conducted with 6 children’s authorized representatives, no disclosures were made regarding this allegation.
During review of the Parent Handbook, it states, “Please provide us with freshly prepared bottles and food daily.” LPA reviewed Infant Room Standard Operating Procedures, which states, “The introduction of solid foods will depend on the infant’s readiness and only with the permission of the parents or guardians. Infants should be able to sit independently, hold their heads steadily, open their mouths when a spoon approaches,

SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Alanna Gontarek
LICENSING EVALUATOR SIGNATURE:	DATE: 07/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2022

LIC9099 (FAS) - (06/04)

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Control Number 06-CC-20220420084845

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 COSTA MESA	FACILITY NUMBER: 304371505
	VISIT DATE: 07/08/2022

NARRATIVE

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and swallows easily.” LPA reviewed the Diet Restriction Letter, completed for C1, by C1’s authorized representative. LPA observed Diet Restriction Letter stating reason for C1’s diet is, “Personal Preference” stating C1 authorized representative will be providing C1 with food and snacks.
Pertaining to the allegation: Staff are not properly documenting day care child's feeding, Per 5 out of 5 staff interviewed, 5 staff stated that staff immediately document a child’s feeding, after being fed, into the Tadpoles application. S4 stated that staff will document children’s daily activities, including meals and mealtimes, on a white board inside the classroom, as a way of communicating children’s activities to the parents as well. During review of Tadpole application for C1, it was observed that staff did document C1’s food intake for dates 3/8/22 to 4/14/22. LPA observed bottles were offered to C1 approximately every 2 to 4 hours. There were 0 to 8 ounces consumed by C1. LPA observed bottles offered more frequently if C1 consumed 0 to 1 ounces or solid foods were offered in between bottles. Feeding times varied. During review of the Parent Handbook, it stated, “Please provide us with freshly prepared bottles and food daily.” During review of Tadpole application for C1, LPA observed C1 was offered both C1’s premade bottles and solid foods, provided by C1’s authorized representative, during C1’s feeding times in C1’s Tadpole daily report for dates 3/8/22 to 4/14/22. LPA observed, in C1’s Tadpole daily reports, how many ounces were offered and how many ounces C1 consumed, or, the solid foods offered that were eaten or denied. LPA reviewed the Diet Restriction Letter, completed for C1, by C1’s authorized representative. LPA observed Diet Restriction Letter stating reason for C1’s diet is, “Personal Preference” stating C1 authorized representative will be providing C1 with food and snacks.
During interviews conducted with 6 children’s authorized representatives from the Infant Room and Preschool room, 1 out of 6 children’s authorized representatives, from the Preschool program, stated the Tadpole daily reports are completed 3 to 4 days a week on average, and are missing details regarding toileting, feeding, and napping. No other disclosures were made regarding above allegations.
On 7/08/2022, LPA toured Room I, younger infant room ages 6 weeks to 18 months, and observed a white board on the wall, that listed bottles, food, nap times, and diaper changing times for each child present in the room. Per Director, the board is used as a visual reminder for staff for estimated times of each child's individual feeding, diapering, and napping schedules.
Based on C1’s authorized representative providing food for C1 to eat, C1’s authorized representative’s verbal approval of C1 eating solid foods, no staff disclosures made of S4 force feeding C1 with a spoon, and Tadpole documentation observed for C1’s meals and meal times, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is unsubstantiated.

SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Alanna Gontarek
LICENSING EVALUATOR SIGNATURE:	DATE: 07/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2022

LIC9099 (FAS) - (06/04)

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Control Number 06-CC-20220420084845

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 COSTA MESA	FACILITY NUMBER: 304371505
	VISIT DATE: 07/08/2022

NARRATIVE

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Notice of Site Visit was posted. The notice of site visit must be posted for 30 consecutive days. Failure to post will result in civil penalties of $100. The licensee was provided a copy of their appeal right (LIC 9058 1/16) and their signature on this form acknowledges receipt of these rights.

Exit interview was conducted with Director, Tina Trenner.
In the area which was investigated no deficiencies were cited today.

This report ends here.
(End of Report)

SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Alanna Gontarek
LICENSING EVALUATOR SIGNATURE:	DATE: 07/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2022

LIC9099 (FAS) - (06/04)

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