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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304313565
Report Date: 05/24/2022
Date Signed: 05/24/2022 03:58:51 PM

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
05/13/2022 and conducted by Evaluator Pat Rivas
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20220513083709
FACILITY NAME:HERNANDEZ-GARCIA, ALBAFACILITY NUMBER:
304313565
ADMINISTRATOR:HERNANDEZ-GARCIA, ALBAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(949) 929-5994
CITY:IRVINESTATE: CAZIP CODE:
92612
CAPACITY:14CENSUS: 11DATE:
05/24/2022
UNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Alba Hernandez-GarciaTIME COMPLETED:
04:00 PM
ALLEGATION(S):
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Children not allowed to sleep
Licensee handles children in an inappropriate manner.
Licensee forcing child(ren) to eat.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) P Rivas conducted an unannounced complaint visit to render findings of the above allegations. LPA was assisted by . Licensee Alba Hernandez Garcia. A tour of the facility was conducted, and a census was taken. Observed at the time of the visit was 4 infants and 7 pre school age children, licensee and 2 assistants.
A review of staff criminal clearance records on this date indicates all facility residents, staff, or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

On 05/13/22, the Department received a complaint alleging that 1) children are not allowed to sleep 2) Licensee handled day care child(ren) in an inappropriate manner 3) Licensee forced child to eat.
The investigation consisted of interview with Four(4) parents; 1) assistant and two witnesses and licensee and review of facility records and LPA observations. LPA attempted to qualify 5 children but was unable to qualify any children for interviews.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Rina Lopez
LICENSING EVALUATOR NAME: Pat Rivas
LICENSING EVALUATOR SIGNATURE:

DATE: 05/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2022
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 6
Control Number 06-CC-20220513083709
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: HERNANDEZ-GARCIA, ALBA
FACILITY NUMBER: 304313565
VISIT DATE: 05/24/2022
NARRATIVE
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page 2


In reference to the allegation that children are not allowed to sleep: Interview with two witnesses indicated that when children were falling asleep during lunch time because the younger children were used to sleeping earlier and had a hard time staying awake during lunch. Witnesses indicated licensee would take children to restroom and wash their face to wake them. Therefore, preventing them from sleeping. Two witnesses reported that children would return to table crying. Interview with licensee indicated she would use a “wipie” to clean their face and take them to restroom to wash hands but denied throwing water on them to keep awake. Licensee further denied keeping children awake. Interview with four parents did not divulge any information. LPA was unable to qualify any children for interview. LPA was able to corroborate allegation therefore the allegation is substantiated.


In reference to the allegation that licensee handled day care children in an inappropriate manner;
Interview with four of four parents did not divulge that licensee handled children in a rough manner. Staff interviewed denies seeing licensee handle children in a rough manner. Licensee denies handling children in a rough manner. Two witnesses indicated they both had observed licensee Alba Hernandez Garcia, at different times and different dates handling different children in a rough manner by pulling on children's shirts, in order to move them or redirect them. Based on the available information the allegation is substantiated.

In reference to the allegation that licensee forced child to eat;
Interview with four of four parents did not divulge that licensee forced child to eat;. Staff interviewed denies seeing licensee forcing a child to eat . Licensee denies forcing a child to eat, furthermore licensee stated child in question tends to gag with food. LPA P Rivas observed lunch being served this date, but licensee was not assisting with feeding children. Two witnesses indicated they both had observed licensee Alba Hernandez Garcia forcing a child to to eat by forcing a spoon with food into the child's mouth causing child to gag, and vomit. Based on the available information the allegation is substantiated
SUPERVISORS NAME: Rina Lopez
LICENSING EVALUATOR NAME: Pat Rivas
LICENSING EVALUATOR SIGNATURE:

DATE: 05/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2022
LIC9099 (FAS) - (06/04)
Page: 4 of 6
Control Number 06-CC-20220513083709
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: HERNANDEZ-GARCIA, ALBA
FACILITY NUMBER: 304313565
VISIT DATE: 05/24/2022
NARRATIVE
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page 3

Based on interviews which were conducted record review(s), the preponderance of evidence standard has been met, therefore the above allegation(s) are found to be substantiated. California Code of Regulations, Title 22, Division 12 and Chapter 1 are being cited on the attached LIC 9099D.

LPA Patricia Rivas informed licensee Alba Hernandez Garcia that this report dated 05/24/2022 document(s) (2) Type A citation(s) 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 P Rivas informed the licensee Alba Hernandez Garcia to provide a copy of this licensing report dated 05/24/22 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 thedate 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.

An exit interview was conducted with Licensee Alba Hernandez Garcia Appeal Rights were explained. The licensee r was provided a copy of appeal rights (LIC 9058) 01/16) 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. First level appeals should be sent to the Regional Manager to the address listed.

The Notice of Site Visit was given and discussed it must be posted as required by H & S Code Sec. 1596.817. Notice of Site Visit must be posted for 30 consecutive days. Failure to post will result in civil penalties of $100.00.

SUPERVISORS NAME: Rina Lopez
LICENSING EVALUATOR NAME: Pat Rivas
LICENSING EVALUATOR SIGNATURE:

DATE: 05/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 6
Control Number 06-CC-20220513083709
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: HERNANDEZ-GARCIA, ALBA
FACILITY NUMBER: 304313565
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/24/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/25/2022
Section Cited
CCR
102423(a)(1)
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Personal Rights
To be treated with dignity in his/her personal relationship with staff and other persons. This regulation was not followed as evidenced by two witness statements reporting that licensee Alba Hernandez Garcia pulled on children's shirts; One
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licensee stated if it happened it is not usual ; but will submit certification of review of personal rights video on CCLD website and certification that she will not violate child's personal rights.
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witness further stating"Alba often also grabs children by their shirts and pulls them "like dogs. 2 witness statements indicating licensee had forced
This poses an immediate hazard to children in care
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Type A
05/25/2022
Section Cited
CCR
102423(a)4
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Personal Rights
interference with eating, sleeping or toileting; or withholding shelter, clothing, medication or aids to physical functioning.his regulation was not met as evidenced by two witness statements indicating when child was forced to eat food Alba caught the food
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licensee stated if it happened it is not usual ; but will submit certification of review of personal rights video on CCLD website and certification that she will not violate child's personal rights.
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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: Rina Lopez
LICENSING EVALUATOR NAME: Pat Rivas
LICENSING EVALUATOR SIGNATURE:

DATE: 05/24/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 6
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
05/13/2022 and conducted by Evaluator Pat Rivas
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20220513083709

FACILITY NAME:HERNANDEZ-GARCIA, ALBAFACILITY NUMBER:
304313565
ADMINISTRATOR:HERNANDEZ-GARCIA, ALBAFACILITY TYPE:
810
ADDRESS:1 BANYAN TREETELEPHONE:
(949) 929-5994
CITY:IRVINESTATE: CAZIP CODE:
92612
CAPACITY:14CENSUS: 11DATE:
05/24/2022
UNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Alba Hernandez Garcia, LIcenseeTIME COMPLETED:
04:00 PM
ALLEGATION(S):
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2
3
4
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9
Child had unexplained injury while in care
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) P Rivas conducted an unannounced complaint visit to render findings of the above allegations. LPA was assisted by . Licensee Alba Hernandez Garcia. A tour of the facility was conducted, and a census was taken. Observed at the time of the visit was 4 infants and 7 pre school age children, licensee and 2 assistants.
A review of staff criminal clearance records on this date indicates all facility residents, staff, or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

On 05/13/22, the Department received a complaint alleging that a child had unexplained injury while in care.
The investigation consisted of interview with Four(4) parents; 1) assistant and two witnesses and licensee and review of facility records and LPA observations. LPA attempted to qualify 5 children but was unable to qualify any children for interviews.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Rina Lopez
LICENSING EVALUATOR NAME: Pat Rivas
LICENSING EVALUATOR SIGNATURE:

DATE: 05/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 5 of 6
Control Number 06-CC-20220513083709
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: HERNANDEZ-GARCIA, ALBA
FACILITY NUMBER: 304313565
VISIT DATE: 05/24/2022
NARRATIVE
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 page 2
Interview with four of four parents did not divulge that licensee caused an unexplained injury to child, nor that the injury happened in the day care. Interview with staff indicated they noted injury (scratches to butt) on child when changing diaper but was not told where and when it had happened. Licensee denies causing the scratches. States some children scratch themselves due to skin conditions. LPA could not corroborate allegation.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated
SUPERVISORS NAME: Rina Lopez
LICENSING EVALUATOR NAME: Pat Rivas
LICENSING EVALUATOR SIGNATURE:

DATE: 05/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2022
LIC9099 (FAS) - (06/04)
Page: 6 of 6