304371213-9-25-2023-06-CC-JHAN-CWGR9G-20231010124928

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 304371213
Report Date: 09/25/2023
Date Signed: 09/25/2023 03:30:32 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
08/23/2023 and conducted by Evaluator Nguyen K Tran

PUBLIC

COMPLAINT CONTROL NUMBER: 06-CC-20230823094216

FACILITY NAME:	LEPORT-IRVINE SPECTRUM-SOUTH CAMPUS		FACILITY NUMBER:	304371213
ADMINISTRATOR:	RIVAS, ANA		FACILITY TYPE:	850
ADDRESS:	1 TECHNOLOGY DRIVE, BLDG H		TELEPHONE:	(949) 525-9922
CITY:	IRVINE	STATE: CA	ZIP CODE:	92618
CAPACITY:	156	CENSUS: 80	DATE:	09/25/2023
		UNANNOUNCED	TIME BEGAN:	02:30 PM
MET WITH:	Wendy Decosta, Bussiness Manager		TIME COMPLETED:	03:45 PM

ALLEGATION(S):

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Facility staff left child unsupervised.
Lack of supervision resulted in child sustaining injury.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Nguyen Nick Tran conducted an unannounced complaint inspection to deliver the findings for the above allegations. This is a continuation of the investigation initiated on 08/25/23. At 2:30pm, LPA Tran met with Business Manager Wendy Decosta, who guided LPA on tour of the facility. Census was taken and observed were 80 children and 16 staff.

A review of the Facility Personnel Report Summary on 09/25/2022 indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

On 08/23/2023, the Regional Office received a complaint with allegations alleging (1) facility staff left child unsupervised and (2) lack of supervision resulted in child sustaining injury.

(Continue next page)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Nguyen K Tran
LICENSING EVALUATOR SIGNATURE:	DATE: 09/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2023

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 3

Control Number 06-CC-20230823094216

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: LEPORT-IRVINE SPECTRUM-SOUTH CAMPUS	FACILITY NUMBER: 304371213
	VISIT DATE: 09/25/2023

NARRATIVE

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(Page 2 of Report)

During a confidential interview, Reporting Party (RP) reported that RP heard from Adult #1 (A1) that there was an incident occurred at facility when Child #1 (C1) got injured while using the paper towel dispenser and that C1 wasn't being supervised when the incident occurred. According to RP, A1 was not present during the incident. LPA contacted A1 and left a message to inquire information about how A1 knew that C1 wasn't being supervised during the incident, A1 did not respond.

LPA contacted former LPA Gutierrez, who conducted a case management (CM) on 11/10/2022 regarding the incident, former LPA Gutierrez confirmed that during the CM at the facility, it was confirmed that staff were present and supervised child when the incident occurred.

During investigation, LPA interviewed 6 staff including one former staff who witnessed the incident and 4 children; reviewed the UIR of the incident and Case Management notes from former LPA.

All interviewed staff denied that they have witnessed or heard of any staff allowing children to go to the bathroom by themselves. Staff who were present in the classroom on the day of the incident confirmed that they were in the bathroom and provided supervision when the incident occurred. All interviewed children denied that they were allowed to go to the bathroom by themselves, and staff always positioned nearby the door to supervise child in the bathroom.

During record reviewed, LPA Tran learned that former LPA Gutierrez had conducted a case management on 11/10/2022 and had interviewed the staff who were present on the day of the incident. The responses from interviewed staff on 11/10/2022 were consistent with the responses provided by interviewed staff during the investigation.

Based on the information gathered from LPA interviews conducted with 6 staffs and 4 children, and record reviews of case management on 11/10/2022, there is insufficient evidence to corroborate the allegations that (1) facility staff left child unsupervised and (2) lack of supervision resulted in child sustaining injury. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove (1) facility staff left child unsupervised and (2) lack of supervision resulted in child sustaining injury did or did not occur, therefore the allegations are UNSUBSTANTIATED. (Continue next page)

SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Nguyen K Tran
LICENSING EVALUATOR SIGNATURE:	DATE: 09/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 06-CC-20230823094216

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: LEPORT-IRVINE SPECTRUM-SOUTH CAMPUS	FACILITY NUMBER: 304371213
	VISIT DATE: 09/25/2023

NARRATIVE

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(Page 3 of Report)

Appeal Rights were explained. The Business Manager was provided a copy of 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. First level appeals should be sent to the regional manager to the address listed above. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with Business Manager Wendy Decosta.

(End of Report)

SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Nguyen K Tran
LICENSING EVALUATOR SIGNATURE:	DATE: 09/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2023

LIC9099 (FAS) - (06/04)

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