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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304270907
Report Date: 02/07/2024
Date Signed: 02/07/2024 09:42:24 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY CC RO, 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
02/06/2024 and conducted by Evaluator Anna Francesca Chan
COMPLAINT CONTROL NUMBER: 06-CC-20240206105008
FACILITY NAME:HILLSBOROUGH PRIVATE SCHOOLFACILITY NUMBER:
304270907
ADMINISTRATOR:POWERS, LAURENFACILITY TYPE:
850
ADDRESS:4757 VALLEY VIEWTELEPHONE:
(714) 572-5696
CITY:YORBA LINDASTATE: CAZIP CODE:
92886
CAPACITY:97CENSUS: 19DATE:
02/07/2024
UNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Director Amy HalitTIME COMPLETED:
10:00 AM
ALLEGATION(S):
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Staff does not ensure facility is not in disrepair.
INVESTIGATION FINDINGS:
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On 02/07/24 at 8:30am, Licensing Program Analyst (LPA) Anna Chan made an unannounced visit to facility for the purpose of a complaint that was received by the regional office on 02/06/2024. LPA met Director Amy Halit. LPA explained the reason for today's visit upon arrival. Census was taken in individual classrooms. LPA observed 19 preschool children and 3 staff.

A review of the Facility Personnel Report Summary on this date indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. During the visit, it was determined the facility is operating within its licensed capacity and within compliance of staffing ratios.

On 02/06/24 a complaint was received alleging Staff does not ensure facility is not in disrepair.

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Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Martha Malane
LICENSING EVALUATOR NAME: Anna Francesca Chan
LICENSING EVALUATOR SIGNATURE:

DATE: 02/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2024
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 3
Control Number 06-CC-20240206105008
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: HILLSBOROUGH PRIVATE SCHOOL
FACILITY NUMBER: 304270907
VISIT DATE: 02/07/2024
NARRATIVE
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LPA interviewed staff, staff 1 (S1) stated the ceiling in the blue room has had a leak since last week when it started to rain around the beginning of February. S1 also stated the lights are flickering and there is water on the light covers. Staff 2 (S2) stated that there was a leak in Green room last week and currently no more leaks. S2 also stated there is water on the light covers. Staff 3 (S3) stated service is pending to repair the roof and check the leaks.

Upon LPAs observation, the ceiling in Blue Room is dripping and there are 2 buckets with water from the drips. It is also observed that the ceiling in the Blue room is peeling and the light cover has water and the cover is discolored. LPA took pictures of the ceiling and took videos while water is dripping from the ceiling. While touring the facility, LPA observed another Room, Green room, with lights that has water on the cover. LPA also observed that the Yellow room ceiling close to the corner of the room is caving in with a little bit of peeling of the paint.

Based on LPA observations of the rooms and the leaks, and interviews with the staff, the preponderance of evidence standard has been met, therefore the above allegations is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division & Chapter 12, is being cited on the attached LIC 9099D for the deficiency section 101238(a) Buildings and Grounds.

Exit interview conducted and report was reviewed with the Director Amy Halit. A notice of site visit was given and must remain posted for 30 days.



Appeal Rights and deficiencies were discussed. The facility representative was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days.
SUPERVISORS NAME: Martha Malane
LICENSING EVALUATOR NAME: Anna Francesca Chan
LICENSING EVALUATOR SIGNATURE:

DATE: 02/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 06-CC-20240206105008
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: HILLSBOROUGH PRIVATE SCHOOL
FACILITY NUMBER: 304270907
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/07/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/07/2024
Section Cited
CCR
101238(a)
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101238 Buildings and Grounds (a) 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 requirement was not met by:
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The Director stated that a work order was requested and the repair company will work on repairs. Director also stated that she will send proof showing the roof has been repaired by POC due date of 3/7/24
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Based on interview and LPA observation, the ceiling in blue room is leaking and peeling. There is some peeling on the ceiling on yellow room and the green room was leaking last week and the light covers have water.
This poses a potential risk to the health and safety of children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Martha Malane
LICENSING EVALUATOR NAME: Anna Francesca Chan
LICENSING EVALUATOR SIGNATURE:

DATE: 02/07/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2024
LIC9099 (FAS) - (06/04)
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