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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304371091
Report Date: 02/03/2022
Date Signed: 03/01/2022 10:38:16 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
01/28/2022 and conducted by Evaluator Dean Valencia
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20220128150154
FACILITY NAME:KINDERLAND ACADEMYFACILITY NUMBER:
304371091
ADMINISTRATOR:SALCEDO, MIRIAMFACILITY TYPE:
850
ADDRESS:1170 W. CIVIC CENTER DRIVETELEPHONE:
(714) 280-4222
CITY:SANTA ANASTATE: CAZIP CODE:
92703
CAPACITY:42CENSUS: 34DATE:
02/03/2022
UNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Miriam SalcedoTIME COMPLETED:
12:00 PM
ALLEGATION(S):
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Facility is operating out of ratio.
Facility staff are not taking precautions for COVID-19.
INVESTIGATION FINDINGS:
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This is an amended document* A complaint inspection was conducted on this date, 2/3/22 by Licensing Program Analyst (LPA) Dean Valencia. LPA met with director Miriam Salcedo to discuss the above allegations. During the inspection, a physical plant inspection/walk-through was conducted, census was taken, facility staff were interviewed, and a facility roster was gathered. At the time of the physical plant inspection/walk-through, 34 children were in care being supervised by 8 staff. On 1/28/22 a complaint was filed alleging Facility is operating out of ratio and Facility staff are not taking precautions for COVID-19. During the course of the investigation, LPA conducted a physical plant inspection/walkthrough, and interviewed 6 staff. Based on LPA's observations of the facility, these allegations of facility operating out of ratio and staff are not taking precautions for covid19, are both determined to be substantiated. LPA reviewed and gathered child sign in/out sheets and reviewed and collected staff timesheets, At the time of the inspection LPA observed ratios of staff to children in the classrooms to be in compliance, however, in the 2s classroom, of the 5 children in care, 3 were under the age of 2 (see Confidential Names List LIC811). The facility is not licensed to care for children under the age of 2 years of age. (continued on LIC9099C)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Dean Valencia
LICENSING EVALUATOR SIGNATURE:

DATE: 02/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2022
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 5
Control Number 06-CC-20220128150154
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: KINDERLAND ACADEMY
FACILITY NUMBER: 304371091
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/03/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/17/2022
Section Cited
CCR
101223(a)(2)
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To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs.
This was not met as evidenced by:

Based on physical plant inspection by LPA, it was observed that 0 of the 32 children age 2 and above, needing to be wearing a face
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The director stated they will send a mass email to all parents enrolled informing them of CDPH covid19 Guidance regarding face coverings for children. They will also speak with all staff regarding this CDPH covid19 Guidance. Proof of this correction will be emailed to LPA by 2/17/22.
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covering per CDPH's covid19 Guidance, were not. This is a potential threat to the children's health and safety.
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CCR
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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: Judy Hanson
LICENSING EVALUATOR NAME: Dean Valencia
LICENSING EVALUATOR SIGNATURE:

DATE: 02/03/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2022
LIC9099 (FAS) - (06/04)
Page: 5 of 5
Control Number 06-CC-20220128150154
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: KINDERLAND ACADEMY
FACILITY NUMBER: 304371091
VISIT DATE: 02/03/2022
NARRATIVE
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(page 2) *This is an amended document*
In addition, it was observed by LPA that of the 31 children in care needing to be wearing face coverings while in care indoors, per CDPH's covid19 Guidance, were not wearing face coverings. Based on the information gathered today by LPA, it was determined that the preponderance of evidence standard was met and the allegations are substantiated. The substantiated allegations constitutes a violation of Personal Rights, and Capacity/Ratio; Title 22 Regulation sections 101223(a)(2), and 101161(a).

The 1 B violation and 1 A violation can be reviewed on the attached LIC9099D pages. Based on the LPA's gathered information, the preponderance of evidence standard has been met, and therefore the above allegations are found to be substantiated. Based on LPA's observations and interviews the following violations is being cited in accordance with California Code of Regulations, Title 22, Division 12, Chapter 3, Section 101223(a)(2), and 101161(a).

Due to the A violation cited during today's inspection, the licensee shall post and provide copies of the report to parents/guardians of the children in care at the facility by the next business day, and shall provide to the parents/guardians of children newly enrolled at the facility during the next 12 months. In addition, the licensee shall immediately post upon receipt the Proof of Correction for 30 consecutive days and provide a copy to current and enrolling parents. The licensee is to keep Acknowledgement Receipt (LIC 9224) signed by parents in each child’s file. Failure to post Type A reports for 30 days will result in a Civil Penalty of $100.00

Appeal Rights and deficiencies were discussed. The facility representative was provided a copy of their appeal rights (LIC 9058) 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. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the director.
SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Dean Valencia
LICENSING EVALUATOR SIGNATURE:

DATE: 02/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 06-CC-20220128150154
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: KINDERLAND ACADEMY
FACILITY NUMBER: 304371091
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/03/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/03/2022
Section Cited
CCR
101161(a)
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A licensee shall not operate a child care center beyond the conditions and limitations specified on the license, including the capacity limitation. This was not met as evidenced by:

Based on LPA's observations, in the 2s classroom, of the 5 children being cared
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The director stated the 3 children will be picked up immediately and will not return to care. Director stated they acknowledge the mistake of enrolling children beyond the scope of their license capacity/ratio, and will not do so again.
*This is a repeat violation cited previously on 12/2/2021 and civil penalty has been assessed
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for, 3 were under the age of 2. The facility is not licensed to provide care for children under the age of 2. This presents an immediate risk to the children's health and safety.
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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: Judy Hanson
LICENSING EVALUATOR NAME: Dean Valencia
LICENSING EVALUATOR SIGNATURE:

DATE: 02/03/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 5