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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304371160
Report Date: 02/15/2022
Date Signed: 02/15/2022 04:08:17 PM

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
02/07/2022 and conducted by Evaluator Dean Valencia
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20220207121552
FACILITY NAME:RAINBOW RISING - CULVERDALEFACILITY NUMBER:
304371160
ADMINISTRATOR:DO, VIFACILITY TYPE:
840
ADDRESS:2 PASEO WESTPARKTELEPHONE:
(949) 296-6296
CITY:IRVINESTATE: CAZIP CODE:
92614
CAPACITY:189CENSUS: 36DATE:
02/15/2022
UNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Vi Do, director TIME COMPLETED:
04:45 PM
ALLEGATION(S):
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Child wondered off from the childcare facility.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Dean Valencia conducted an unannounced complaint inspection on today's date, 2/15/22. At 2pm LPA conducted a tour of the facility and census of children was taken. LPA observed 34 children and 5 staff. On 2/7/22 a complaint was filed with the Department alleging the above. During the course of the investigation, LPA interviewed the director and 1 other staff, a child #1, conducted a separate physical plant inspection of each classroom, and gathered facility documentation related to the allegation. Based on the information obtained it has been determined that at approximately 5pm on 1/20/22 a child #1, left the supervision of 4 staff, (see Confidentail Names List LIC811), and went to play at a play structure approximately 300 feet from the facility's licensed shared play structure where a group of 26 children were outside. This other play structure off the campus of Culverdale Elementary where the licensed school age faciltiy is located is approximately 1000 feet from the licensed classrooms. Adult #1 arrived to obtain the child #1, and it was determined by director and adult #1 at that time that child #1 was not in either classroom, and had not returned with the group from outside.
(continued on LIC9099C)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Dean Valencia
LICENSING EVALUATOR SIGNATURE:

DATE: 02/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/15/2022
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 4
Control Number 06-CC-20220207121552
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: RAINBOW RISING - CULVERDALE
FACILITY NUMBER: 304371160
VISIT DATE: 02/15/2022
NARRATIVE
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(page 2)
After approximately 11 minutes of searching the campus and grounds, at 5:55pm child was discovered approximately 1000 feet from the licensed classrooms, unsupervised. Child #1 was located at the play structure off the campus of Culverdale Elementary School approximately 300 feet from the licensed shared play structure and approximately 1000 feet from the licensed classrooms of the facility. Irvine PD was notified and an officer assisted in the search for child #1. Child #1 was retrieved and returned to adult #1. Facility then self reported the incident to CCL office on 1/21/22. The facility has since put into place and began practicing written head counts of all children before leaving the outdoor play structure as well as again as soon as the staff and children arrive at the licensed classrooms which are approximately 700 feet away from the licensed shared play structure. The facility has also implemented a written list of all children in each grade level to be kept on staff's lanyard at all times to reference, so all staff are aware of all children enrolled and what children are with what staff, at all times. In addition to these procedures put into place as a result of this incident, the director will be submitting an email to LPA detailing all that has been done as correction for this incident and what has been discussed with staff at the facility as a result. Pictures of the grounds described above were taken by LPA at the time of this inspection and are on file.

Based on the information gathered today by LPA, it was determined that the preponderance of evidence standard was met and the allegation is substantiated. The substantiated allegation constitutes a violation of Supervision; Title 22 Regulation section 101229(a)(1).The A violation can be reviewed on the attached LIC9099D page. 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: 02/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/15/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 06-CC-20220207121552
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: RAINBOW RISING - CULVERDALE
FACILITY NUMBER: 304371160
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/15/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/15/2022
Section Cited
CCR
101229(a)(1)
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No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation. This was not met as evidenced by:
Based on interview and review of records of the unusual incident on 1/20/22, it was
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The director discussed with LPA the procedures that have been put into place as a result of this incident. Facility has begun doing a more thorough log of the head counts of children both before coming in from outside at the play structure and again as soon as they return to the classrooms. All staff each have a list of all children enrolled in the
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determined that a child #1 wandered away from the supervision of staff, and was undupervised for approximately 55 minutes at a play structure nearby the campus of Culverdale Elementary. This structure is approximately 1000 feet from the licensed facility. This is an immeidate threat to the child's health, safety and personal rights.
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licensed program listed by grade level so staff are aware fo the child groups for each staff. Additionally director will be sending LPA an email of proof of these corrections and what has been discussed with the facility staff as a result of this incident. This email will be submitted to LPA 2/15/22.
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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: 02/15/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/15/2022
LIC9099 (FAS) - (06/04)
Page: 4 of 4