304370734-12-19-2023-06-CC-MMAE-D22RQM-20240201121340

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 304370734
Report Date: 12/19/2023
Date Signed: 12/19/2023 02:24:20 PM

Unsubstantiated

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
11/03/2023 and conducted by Evaluator Anna Francesca Chan

PUBLIC

COMPLAINT CONTROL NUMBER: 06-CC-20231103161859

FACILITY NAME:	FUN 4 KIDS PRESCHOOL		FACILITY NUMBER:	304370734
ADMINISTRATOR:	SILVA, DAWN		FACILITY TYPE:	850
ADDRESS:	23721 LA PALMA AVENUE		TELEPHONE:	(714) 694-0901
CITY:	YORBA LINDA	STATE: CA	ZIP CODE:	92887
CAPACITY:	76	CENSUS: 30	DATE:	12/19/2023
		UNANNOUNCED	TIME BEGAN:	12:46 PM
MET WITH:	Director Melissa Wojick		TIME COMPLETED:	01:40 PM

ALLEGATION(S):

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Health Related Services

INVESTIGATION FINDINGS:

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On 12/19/2023, at 11:55am Licensing Program Analyst (LPA), Anna Chan conducted an unannounced Complaint investigation inspection. This is a continuation of the investigation initiated on 11/9/2023. Upon arrival, LPA met with Director, Melissa Wojick and informed the director of the purpose of the visit is to deliver findings. LPA was led on walk through of the facility by the director and a census was taken. LPA observed 4 staff and 30 preschool children.

A review of 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 clearance.

The Department received a complaint on 11/03/2023 alleging that Facility did not return an expired medication to child's parent.
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Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Anna Francesca Chan
LICENSING EVALUATOR SIGNATURE:	DATE: 12/19/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 06-CC-20231103161859

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: FUN 4 KIDS PRESCHOOL	FACILITY NUMBER: 304370734
	VISIT DATE: 12/19/2023

NARRATIVE

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Interview with the complainant: On 11/7/2023, the LPA called the reporting party (RP), according to the interview, RP stated that prior to this incident, in December 2022 or January 2023 RP provided the facility with new prescription EpiPen, RP then asked the facility to return the expired medication, but facility could not locate the medication. But medication was given back after.

Interview with staff: On 12/19/2023, LPA interviewed one staff, Staff #3 (S3). S3 stated that when Parent (P1) asked for the expired medication, first, they could not locate the medication, but were able to find it the same day in C1s classroom inside the teachers cabinet. S3 called P1 that medication is found. P1 stated it will be picked up the following day.

Based on the interviews conducted and records review, the preponderance of evidence standard has not been met. 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.

An exit interview was conducted with Director, Melissa Wojick, The Notice of Site Visit was posted during the visit. The Director 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. The director was provided with 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: Anna Francesca Chan
LICENSING EVALUATOR SIGNATURE:	DATE: 12/19/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2023

LIC9099 (FAS) - (06/04)

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