<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304370638
Report Date: 08/16/2024
Date Signed: 08/16/2024 01:15:16 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 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
06/20/2024 and conducted by Evaluator Archibaldo Silva
COMPLAINT CONTROL NUMBER: 06-CC-20240620163652
FACILITY NAME:BUENA PARK EARLY HEAD STARTFACILITY NUMBER:
304370638
ADMINISTRATOR:JOSEPHINE HERNANDEZFACILITY TYPE:
830
ADDRESS:6625 DALE STREETTELEPHONE:
(714) 241-8920
CITY:BUENA PARKSTATE: CAZIP CODE:
90621
CAPACITY:16CENSUS: 12DATE:
08/16/2024
UNANNOUNCEDTIME BEGAN:
12:42 PM
MET WITH:Director Wendolin HernandezTIME COMPLETED:
01:35 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff did not provide adequate supervision resulting in a child sustaining unexplained injuries.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
***THIS REPORT IS A COPY OF PAGE 1 OF THE REPORT ISSUED ON 8/16/24 FOR COMPLAINT CONTROL NUMBER: 06-CC-20240620163652 AND CONTAINS A CITATION PAGE***

On 8/16/2024 Licensing Program Analyst (LPA) A. Silva conducted an unannounced complaint investigation inspection. This is a continuation of the investigation initiated on 6/26/2024. Upon arrival, the LPA met with Director Wendolin Hernandez and informed the director of the purpose of the visit. The facility personnel report summary shows all facility staff or individuals who require caregiver background checks have received a criminal record clearance and a child abuse index clearance or an exemption. The census at the time of the visit was 12 infants in two rooms. The facility was operating within ratio and capacity.

The Department received a complaint on 6/20/2024 alleging that staff did not provide adequate supervision resulting in a child sustaining unexplained injuries.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Archibaldo Silva
LICENSING EVALUATOR SIGNATURE:

DATE: 08/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2024
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 2
Control Number 06-CC-20240620163652
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: BUENA PARK EARLY HEAD START
FACILITY NUMBER: 304370638
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/16/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/16/2024
Section Cited
CCR
101429(a)(1)
1
2
3
4
5
6
7
101429 Responsibility for Providing Care and Supervision for Infants. (a)(1) Each infant shall be constantly supervised and under direct visual observation and supervision by staff person at all times.
This requirement was not met as evidenced by:
1
2
3
4
5
6
7
The director stated a plan of prevention of challenging behavior is being implemented already, including and Individual Support Plan for a child with challenging behavior. An IInclussion Support Facilitator is involved in supporting the child's needs to prevent future injuries.
8
9
10
11
12
13
14
Based on interviews and records, the requirement was not met for one infant, which poses an immediate risk to the children’s health, safety, or personal rights. Staff admitted that Child 1 was bitten multiple times.
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: Archibaldo Silva
LICENSING EVALUATOR SIGNATURE:

DATE: 08/16/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2