304270205-12-18-2024-06-CC-GLUO-DC424Y-20241218160442

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304270205
Report Date: 12/18/2024
Date Signed: 12/18/2024 04:04:47 PM

Document Has Been Signed on 12/18/2024 04:04 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME:	CHILDTIME CHILDREN'S CENTER		FACILITY NUMBER:	304270205
ADMINISTRATOR/ DIRECTOR:	ONTIVEROS, NICOLE		FACILITY TYPE:	840
ADDRESS:	1000 SOUTH STATE COLLEGE		TELEPHONE:	(714) 772-7225
CITY:	ANAHEIM	STATE: CA	ZIP CODE:	92806
CAPACITY: 19	TOTAL ENROLLED CHILDREN: 19	CENSUS: 0	DATE:	12/18/2024
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	02:25 PM
MET WITH:	Director Nichole Ontiveros		TIME VISIT/ INSPECTION COMPLETED:	04:20 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	(page 1) Licensing Program Analyst (LPA) Giselle Lucero conducted an unannounced case management incident inspection in response to a self-report Unusual Incident dated 12/07/2024. LPA met with Director Nichole Ontiveros. LPA observed there were no school age children present. A review of staff criminal clearance records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. On 12/09/2024, a self reported Unusual Incident Report (UIR) was filed with the Licensing Office. The facility reported on Saturday December 7, 2024, during transition from inside to the outside playground, Staff #1 (S1) took 8 out of the 9 children to the playground, leaving child #1 (C1) in the classroom. Staff #2 (S2) arrived to their shift, completed the face to name and observed C1 was not outside in the play yard. S1 walked back to the classroom and observe C1 sitting down at the rug. C1 was alone in the classroom for about 7 minutes. On 12/18/2024, LPA interviewed Staff #3 (S3), obtained a copy of staff declarations and incident report for C1. S3 stated S1 transitioned outside to the playground with 8 children. S1 did not complete the face to name and failed to realize C1 was still inside the classroom. When S2 arrived to their shift, S2 completed the face to name and realized C1 was not outside in the playground. S1 assured S2 that C1 was outside but was probably hiding somewhere. S1 walked back to the classroom to bring S2 the ipad and that is when S1 observed C1 inside the classroom. S3 stated video footage of the incident was reviewed and C1 was observed alone in the classroom for 7 minutes. S3 stated C1 was playing inside and did not seem distressed or scared. (continue to page 2)

Judy Hanson	TELEPHONE: (714) 703-2807
Giselle Lucero	TELEPHONE: 714-292-2922
	DATE: 12/18/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2024

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

LIC809 (FAS) - (06/04)

Page: 1 of 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: CHILDTIME CHILDREN'S CENTER	FACILITY NUMBER: 304270205
	VISIT DATE: 12/18/2024

NARRATIVE

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(Page 2)
Based on LPA's interviews, documents obtained and self incident report, it has been determined that C1 was left alone inside the classroom for approximately 7 minutes on 12/07/2024.

The following violation Responsibility for providing care and supervision was revealed today and is being cited in accordance with California Code of Regulations, Title 22, Division 12, Chapter 1, 101229 (a)(1). Please see the attached LIC 809D.

LPA Lucero informed Director Nichole Ontiveros that this report dated 12/18/2024, document(s) one Type A citation which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPA Lucero informed Director Nichole Ontiveros to provide a copy of this licensing report dated 12/18/2024 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

Exit interview conducted and report was reviewed with Director Nichole Ontiveros. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. Appeal Rights and deficiencies were discussed.

End of Report.

SUPERVISOR'S NAME: Judy Hanson	TELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Giselle Lucero	TELEPHONE: 714-292-2922
LICENSING EVALUATOR SIGNATURE:	DATE: 12/18/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2024

LIC809 (FAS) - (06/04)

Page: 2 of 3

Document Has Been Signed on 12/18/2024 04:04 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: CHILDTIME CHILDREN'S CENTER	FACILITY NUMBER: 304270205
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 12/18/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Section Cited

101229 Responsibility for Providing Care and Supervision (a)(1) No child(ren) shall be left without the supervision of a teacher at any time....Supervision shall include visual observation. This requirement was not met as evidenced by: Based on interviews, documents
	Deficient Practice Statement
1 2 3 4
	POC Due Date: 12/18/2024
	Plan of Correction
1 2 3 4	Director stated S1 has been terminated, effective 12/17/2024. Director stated a reminder was sent to all staff regarding supervision and will email LPA a copy of the signed acknowledgement.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

Judy Hanson	TELEPHONE: (714) 703-2807
Giselle Lucero	TELEPHONE: 714-292-2922
	DATE: 12/18/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2024

LIC809 (FAS) - (06/04)

Page: 3 of 3