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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304370232
Report Date: 01/24/2024
Date Signed: 01/24/2024 11:20:59 AM

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
10/27/2023 and conducted by Evaluator Patricia Duron
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20231027114517
FACILITY NAME:KIDDIE ACADEMY OF IRVINEFACILITY NUMBER:
304370232
ADMINISTRATOR:SARA ORTIZFACILITY TYPE:
830
ADDRESS:16655 NOYES AVENUETELEPHONE:
(949) 660-0005
CITY:IRVINESTATE: CAZIP CODE:
92606
CAPACITY:24CENSUS: 7DATE:
01/24/2024
UNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Sara Ortiz, Director TIME COMPLETED:
11:30 AM
ALLEGATION(S):
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Staff handled day-care child in a rough manner.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Patricia Duron conducted an unannounced complaint visit to deliver the complaint findings. This is a continuation of the investigation initiated on 10/31/2023. LPA met with Director, Sara Ortiz and informed the director of the purpose of the visit. At 9:20am the director guided LPA on a tour of the facility and a census was taken. The overall census observed was 5 staff and 7 children.
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 10/27/23 a complaint was filed with the Licensing office alleging staff handled day care child in a rough manner. Reporting Party (RP) stated a staff member went to try and wake a child up by grabbing child by the arm and shaking the child. RP stated that they have noticed that during nap time the staff will pat the children’s backs roughly to make them go to sleep.

Page 1 of 3
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Patricia Duron
LICENSING EVALUATOR SIGNATURE:

DATE: 01/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2024
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 6
Control Number 06-CC-20231027114517
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: KIDDIE ACADEMY OF IRVINE
FACILITY NUMBER: 304370232
VISIT DATE: 01/24/2024
NARRATIVE
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During the course of investigation, LPA interviewed 10 staff members, and 5 parents, and reviewed records. Children were not interviewed due to their age and being non- verbal.

Regarding allegations staff handled day-care child in a rough manner:

LPA interviewed 10 staff members, 10 out of 10 staff stated they have not witnessed any staff handle any day-care child in a rough manner. LPA reviewed video footage dated 10/27/23. LPA observed on video at 10:45am C1 was sleeping on the carpet in the classroom. At 10:46am Staff #1(S1) walks over to C1 and lifts up sleeping child, staff placed their hands under C1’s arm pits. S1 lifts up child about 8 inches from the ground and lowers child again, S1 lifts and lowers C1 several times. C1 knees bend and their knees touch the floor. C1 sat on the carpet on their knees, then S1 lifts child again, and child begins to jump up and down as they move their legs off the ground. C1 places feet on the ground, and S1 holds C1 hand and walks away with child.

LPA Duron interviewed 5 parents. All interviewed parents stated they did not have any concern with facility.

Based on LPA’s interviews, and reviewing video footage, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 12, Chapter 1 Section 101223 Personal Rights (a)(3). Please refer to attached 9099D for documentation of deficiencies.

This requirement is met as evidence by: Based on LPA’s interview and observation of video footage of incident that documents S1 handing C1 in a rough manner, which poses an immediate health risk to the children in care.

LPA Duron informed Director, Sara Ortiz that this report dated 1/24/2024 documents one Type A citation which shall be posted for 30 consecutive days as there is an immediate risk to the health, safety, or personal rights of children in care. LPA Duron informed the Director to provide a copy of this licensing report dated 1/24/2024 that documents any Type A citation 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.

Page 2 of 3

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Patricia Duron
LICENSING EVALUATOR SIGNATURE:

DATE: 01/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 6
Control Number 06-CC-20231027114517
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: KIDDIE ACADEMY OF IRVINE
FACILITY NUMBER: 304370232
VISIT DATE: 01/24/2024
NARRATIVE
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An exit interview was completed. The report was reviewed and discussed. Appeal Rights were provided. The facility representative was provided a copy of their appeal rights and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Licensing office within 15 business days. Any proposed changes to the physical plant, including telephone number, shall be immediately reported to the Department.

The facility representative was informed that the “Notice of Site Visit” must be posted for 30 consecutive days. Failure to post will result in Civil Penalties of $100.00. The “Notice of Site Visit” must be posted on or adjacent to the door.

Page 3 of 3. End of Report

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Patricia Duron
LICENSING EVALUATOR SIGNATURE:

DATE: 01/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 6
Control Number 06-CC-20231027114517
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: KIDDIE ACADEMY OF IRVINE
FACILITY NUMBER: 304370232
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/24/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
01/24/2024
Section Cited
HSC
101224(a)(3)
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101223 Personal Rights(a)(3) The licensee shall ensure that each child is accorded the following personal rights: To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat....aids physical functioning. This requirement is not met as evidence by:
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Director provided LPA with a written statement, stating she will provide training on personal rights to staff on 1/29/24. Director will provide a sign in sheet with staff signatures that attended the training. Director will provide sign in sheet to LPA via email.
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Based on LPA’s record review, LPA reviewed video footage of incident that occurred on 10/27/23.LPA reviewed video footage dated 10/27/23. LPA observed on video at 10:45am C1 was sleeping on the carpet in the classroom. At 10:46am a Staff #1 walks over to C1 and lifts up sleeping child, staff placed their hands under C1’s arm pits. Staff S1 lifts up child about 8 inches from the ground and lowers child again, S1 lifts and lowers C1 several times. C1 knees bend and their knees touch the floor. C1 sat on the carpet on their knees, then S1 lifts child again, and child begins to jump up and down as they move their legs off the ground. C1 places feet on the ground, and S1 holds C1 hand and walks away with child. This action poses an immediate risk to the health and safety to the 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: Thuy Ho
LICENSING EVALUATOR NAME: Patricia Duron
LICENSING EVALUATOR SIGNATURE:

DATE: 01/24/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2024
LIC9099 (FAS) - (06/04)
Page: 4 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
10/27/2023 and conducted by Evaluator Patricia Duron
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20231027114517

FACILITY NAME:KIDDIE ACADEMY OF IRVINEFACILITY NUMBER:
304370232
ADMINISTRATOR:SARA ORTIZFACILITY TYPE:
830
ADDRESS:16655 NOYES AVENUETELEPHONE:
(949) 660-0005
CITY:IRVINESTATE: CAZIP CODE:
92606
CAPACITY:24CENSUS: DATE:
01/24/2024
UNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Sara Ortiz, Director TIME COMPLETED:
11:30 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff shook a child in care.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Patricia Duron conducted an unannounced complaint visit to deliver the complaint findings. This is a continuation of the investigation initiated on 10/31/2023. LPA met with Director, Sara Ortiz and informed the director of the purpose of the visit. At 9:20 am the director guided LPA on a tour of the facility and a census was taken. The overall census observed was 5 staff and 7 children.
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 10/27/23 a complaint was filed with the Licensing office alleging (1) Staff shook a child in care. Reporting Party (RP) stated a staff member went to try and wake a child up by grabbing child by the arm and shaking the child.
During the course of investigation, LPA interviewed 10 staff members, and 5 parents, and reviewed records. Children were not interviewed due to their age and are nonverbal.
Page 1 of 2
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Patricia Duron
LICENSING EVALUATOR SIGNATURE:

DATE: 01/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2024
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-20231027114517
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: KIDDIE ACADEMY OF IRVINE
FACILITY NUMBER: 304370232
VISIT DATE: 01/24/2024
NARRATIVE
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Regarding allegations (1) Staff shook a child in care:

LPA interviewed 10 staff members, 10 out of 10 staff stated they have not witnessed a staff shook a child in care. LPA reviewed video footage dated 10/27/23. LPA observed on video at 10:45am C1 was sleeping on the carpet in the classroom. At 10:46am a Staff #1 walks over to C1 and lifts up sleeping child, staff placed their hands under C1’s arm pits and lifts C1 up. LPA didn’t observe any shaking on the video.

LPA Duron interviewed 5 parents. All interviewed parents stated they did not have any concern with facility.

Based on the information gathered from LPAs’ interviews, observation, and the reviewing of records, there is insufficient evidence to corroborate the allegations of a staff shook a child in care. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the allegations did or did not occur in the day care facility, therefore the allegations are UNSUBSTANTIATED.

An exit interview was completed. The report was reviewed and discussed. Appeal Rights were provided. The facility representative was provided a copy of their appeal rights and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Licensing office within 15 business days. Any proposed changes to the physical plant, including telephone number, shall be immediately reported to the Department.



The facility representative was informed that the “Notice of Site Visit” must be posted for 30 consecutive days. Failure to post will result in Civil Penalties of $100.00. The “Notice of Site Visit” must be posted on or adjacent to the door.

Page 2 of 2. End of the Report.

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Patricia Duron
LICENSING EVALUATOR SIGNATURE:

DATE: 01/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2024
LIC9099 (FAS) - (06/04)
Page: 6 of 6