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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304313924
Report Date: 09/22/2021
Date Signed: 09/22/2021 02:12:15 PM

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
08/13/2021 and conducted by Evaluator Cindy Nguyen
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20210813112425
FACILITY NAME:MORRIS, EVELYNFACILITY NUMBER:
304313924
ADMINISTRATOR:MORRIS, EVELYNFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(949) 923-5235
CITY:IRVINESTATE: CAZIP CODE:
92618
CAPACITY:14CENSUS: 10DATE:
09/22/2021
UNANNOUNCEDTIME BEGAN:
01:10 PM
MET WITH:Licensee, Evelyn MorrisTIME COMPLETED:
02:45 PM
ALLEGATION(S):
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Child sustained injury while in care.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Nguyen conducted an unannounced investigate the above allegation. This is a continuation of the investigation initiated on 08/18/21. LPA meet with licensee, Evelyn Morris and explained the reason for the inspection. At 1:15 pm the licensee guided LPA on a tour of the facility. Present at the time of the inspection was the licensee, licensee’s assistants, and 10 day care children, 4 of which were under the age of two year. During today's inspection staffing ratios were being met and the facility was operating within its licensed capacity. A review of staff criminal records indicates all facility staff or individuals who require caregiver background checks have received a criminal record clearance or exemption and a child abuse index clearance.

On 08/13/2021 a complaint was filed with the Department alleging Child #7 (C7) and Child #6 (C6) sustained injuries while in care. Complainant alleged that C7 was pinched under the arm by Child #2 (C2). Further, it was alleged that C6 had a bruise on the shoulder that was also caused by (C2).

Continued on Page 2
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Cindy Nguyen
LICENSING EVALUATOR SIGNATURE:

DATE: 09/22/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2021
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 2
Control Number 06-CC-20210813112425
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: MORRIS, EVELYN
FACILITY NUMBER: 304313924
VISIT DATE: 09/22/2021
NARRATIVE
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Page 9099C

During the investigation, LPA conducted 2 physical plant inspections, interviewed two staff members, five children, four parents, and reviewed facility roster. All staff interviewed denied ever knowing or observing C2 pinching or hitting C6 or C7. S2 interviewed stated that S2 was outside on the day in question and, there was no hitting or pinching. S2 stated they were there engaging with the children. S2 stated there was no time any of the children cried or any incident that was brought up to S2s attention. S2 believes the pinching and hitting couldn't happened here at the facility. S1 stated that S1 didn’t not observed any scratches nor any marks on C6 and C7 and there was no time any of the children cried. S1 stated it couldn’t happen here at the facility especially the pinching. The children interviewed were either too young to qualify or did not disclosed any information to support the allegation. C6 and C7 were not available to be interviewed. LPA contacted five parents by phone and was able to interview four parents. All four interviewed parents did not express any concerns with the care and supervision given to the children, or any have any other issue with any staff at the facility. Parents stated they would recommend facility to others.

Based on LPA observations, document reviews and interviews which were conducted, the preponderance of evidence was not met, therefore the above allegation is found to be UNSUBSTANTIATED. 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.

Exit interview was conducted with licensee, Evelyn Morris. Notice of Site Visit was posted during the visit. Licensee was informed that the notice of site visit must be posted for 30 consecutive days. Failure to post will result in civil penalties of $100. Licensee was provided a copy of their appeal rights (LIC 9058 01/16) and their signature on this form acknowledges receipt of these rights. First level appeals should be sent to the regional manager to the address listed above.
SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Cindy Nguyen
LICENSING EVALUATOR SIGNATURE:

DATE: 09/22/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 2