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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304310159
Report Date: 05/03/2024
Date Signed: 05/03/2024 10:37:17 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
02/12/2024 and conducted by Evaluator Romelia M Castanon
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20240212133650
FACILITY NAME:PEREIRA, BELINDAFACILITY NUMBER:
304310159
ADMINISTRATOR:PEREIRA, BELINDAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(714) 717-3509
CITY:HUNTINGTON BEACHSTATE: CAZIP CODE:
92646
CAPACITY:14CENSUS: 11DATE:
05/03/2024
UNANNOUNCEDTIME BEGAN:
09:09 AM
MET WITH:TIME COMPLETED:
11:15 AM
ALLEGATION(S):
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Licensee does not spend adequate amount of time at the facility
INVESTIGATION FINDINGS:
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On 05/03/2024, Licensing Program Analyst (LPA) Romy Castanon and Christine Jung made an unannounced visit to the facility to deliver findings of a complaint that was received at the Orange County Regional Child Care Program Office. LPA met with Belinda Pereira and explained the reason for today’s visit. Observed at the time of the visit was a total of 11 children and two (2) assistants.
A review of the Facility Personnel Report Summary on 05/03/2024 indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

On 02/12/2024, the Regional Office received a complaint report alleging Licensee does not spend adequate amount of time at the facility. LPA interview Reporting Party (RP) who stated Licensee would leave the facility every Monday to assist at another family childcare home. RP stated on average, Licensee would leave the facility 2-3 times a week. RP mentioned sometimes licensee would be quick but other times, licensee would not inform anyone in the home that she was leaving, she would notify them when she returned. RP stated more recently, on 02/20/2024, Licensee was absent from the facility from 8:00am-4:00pm. (Continue to page 2)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Romelia M Castanon
LICENSING EVALUATOR SIGNATURE:

DATE: 05/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2024
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-20240212133650
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: PEREIRA, BELINDA
FACILITY NUMBER: 304310159
VISIT DATE: 05/03/2024
NARRATIVE
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 (Page 2) During interview with Licensee, they informed LPA that they open at 7:00am and close at 5:00pm and does not take any time off unless it is an appointment. Licensee stated they attend one appointment a month for about an hour total during their facility’s rest period. Licensee stated their adult son is home if needed. LPA asked about a personal appointment that requested her attendance on 02/20/2024. Licensee stated they closed their facility for the day and no care was provided. Licensee could not provide LPA with a written notice sent to parents, as they were told verbally.

LPA interviewed Assistant #1 (A1) on 02/21/2024, who confirmed on 02/20/2024 there were 13 children in attendance that A1 supervised while Licensee was out of the facility. A1 stated that A1 was alone from 8:30am-4:30pm. During the interview A1 confirmed that licensee was not in the facility from 8am-4pm on Mondays during the month of January 2024.

LPA interviewed four (4) children on 02/22/2024. Children did not make any disclosures regarding allegations of this complaint.

On 03/25/2024, LPA reviewed sign in/out sheets for 02/20/2024. Facility was open and A1 cared for 13 children who attended on 02/20/2024. Sign in/sign out sheets dated 02/20/2024 were signed by parents/guardians by using their full signature and documented the time of day for 11 children.

On 05/02/2024, LPA interviewed an additional witness (W1). W1 confirmed to LPA that Licensee was away from their facility on Monday’s.

Based on LPAs’ interviews conducted, the preponderance of evidence standard has been met, therefore the above allegation Licensee does not spend adequate amount of time at the facility is found to be substantiated. California Code of Regulations, Title 22, Division 12, 102417 Operation of a Family Child Care Home is being cited on the attached LIC9099D.

Appeal Rights were discussed. The Licensee 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. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with Licensee Belinda Pererra. Upon receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. Licensee shall have LIC9224 (Acknowledgement of Receipt) signed and kept in each child's file. (End of Report)

SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Romelia M Castanon
LICENSING EVALUATOR SIGNATURE:

DATE: 05/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 06-CC-20240212133650
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: PEREIRA, BELINDA
FACILITY NUMBER: 304310159
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/03/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type A
05/04/2024
Section Cited
CCR
102417(a)
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102417 Operation of a Family Child Care Home (a) The licensee shall be present in the home and shall... the licensee to be temporarily absent from the home, the licensee shall arrange for a...Temporary absences shall not exceed 20 percent of the hours that the facility is providing care per day. This requirement is not being met as evidenced by:
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Licensee wrote a declaration stating that they would be present at their facility and their absences would not exceed 20 percent of the hours that the facility is providing care per day. Licensee will notifiy the department if an extended absence is needed. Licensee will ensure that the susbstitute staff meets the licensing requirements and is within child/staff ratio. Licensee submitted the declaration during LPA's visit.
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Based on LPA’s interviews conducted, Licensee was absent from their facility on several Mondays. LPA confirmed every Monday during the month of January 2024 from 8:00am-4:00pm the Licensee was away from their facility. During additional interviews, Licensee was away from their facility on 02/20/2024 and left an assistant alone from 8:30am-4:30pm to care for at least 11-13 children by themselves. This poses an immediate health, safety or personal rights risk to persons 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: Patricia Magana
LICENSING EVALUATOR NAME: Romelia M Castanon
LICENSING EVALUATOR SIGNATURE:

DATE: 05/03/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3