304371214-10-3-2023-06-CC-JHAN-CX726H-20231101170710

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 304371214
Report Date: 10/03/2023
Date Signed: 10/03/2023 12:34:38 PM

Substantiated

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
09/29/2023 and conducted by Evaluator Nguyen K Tran

PUBLIC

COMPLAINT CONTROL NUMBER: 06-CC-20230929104432

FACILITY NAME:	LEPORT-IRVINE SPECTRUM-NORTH CAMPUS		FACILITY NUMBER:	304371214
ADMINISTRATOR:	BARTOLOME, KRISTA		FACILITY TYPE:	850
ADDRESS:	1 TECHNOLOGY DRIVE BLDG. A		TELEPHONE:	(949) 427-3968
CITY:	IRVINE	STATE: CA	ZIP CODE:	92618
CAPACITY:	119	CENSUS: 67	DATE:	10/03/2023
		UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Krista Bartolome		TIME COMPLETED:	11:30 AM

ALLEGATION(S):

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Staff did not provide day care child adequate supervision, resulting in child being found in the facility bathroom unsupervised.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Nguyen Nick Tran conducted a 10-Days Initial investigation and delivered findings regarding the allegation about staff did not provide day care child adequate supervision, resulting in child being found in the facility bathroom unsupervised. LPA met with Director Krista Bartolome and informed the Director the purpose of the visit.

During today's investigation, a tour of the facility was conducted. There were 18 preschool children with 2 staff members in Camellia classroom,18 preschool children with 2 staff members in Spruce classroom, 13 preschool children with 2 staff members in Birch classroom, 9 toddlers with 2 staff members in Toddler Elm classroom, and 9 toodlers with 2 staff members in Toddler Juniper classroom. A review of staff records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances.

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Substantiated

Estimated Days of Completion:

SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Nguyen K Tran
LICENSING EVALUATOR SIGNATURE:	DATE: 10/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2023

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-20230929104432

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-NORTH CAMPUS	FACILITY NUMBER: 304371214
	VISIT DATE: 10/03/2023

NARRATIVE

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(Page 2 of Report)

On 09/29/2023, Regional Office received a complaint with allegation regarding staff did not provide day care child adequate supervision, resulting in child being found in the facility bathroom unsupervised.

During a confidential interview, LPA was provided details about an incident that occurred on 09/25/2023 when child #1 (C1) was left unsupervised in the bathroom of the Birch classroom.

During the investigation, LPA interviewed 3 staff, who were involved in the incident occurred on 09/25/2023 and reviewed record of facility incident report.

During record review, the details provided during the confidential interview, matched with a self-report unusual incident that was submitted to Community Care Licensing Regional Office by facility staff #4 (S4) on 09/25/2023. According to the report, the unusual incident occurred on 09/25/2023 at approximately 11:20am in Birch classroom. During the transition to the playground, staff #1 (S1) and staff #2 (S2) completed face-to-name count at 11:20am, however, at 11:45am, staff S1 and S2 were not able to locate (C1) on the playground. Staff informed management team over the radio. At 11:50am, Staff #3, who was delivering the lunches to the classrooms, found C1 in the Birch classroom's bathroom and C1 was crying. C1 was brought to the front office. S4 met with C1 to assess C1, C1 appeared to be fine and C1 was later returned to the playground. C1's parent was notified of the incident and facility management team met with involved staff members to address concerns of supervision during transition.

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SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Nguyen K Tran
LICENSING EVALUATOR SIGNATURE:	DATE: 10/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 06-CC-20230929104432

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-NORTH CAMPUS	FACILITY NUMBER: 304371214
	VISIT DATE: 10/03/2023

NARRATIVE

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(Page 3 of Report)

During the interviews on 09/27/2023, LPA Tran interviewed 3 staff members were involved in the incident occurred on 09/25/2023. All interviewed staff provided consistent details of the incident. S1 stated there were 16 children present in the Birch classroom, on the day of the incident, with two staff members S1 and S2. S1 stated the class went outside to the playground at approximately 11:15 a.m. S1 reported the children lined up to go outside to the playground, S1 was in the front of the line and S2 was in the back of the line. S1 stated S1 conducted face-to-name count using the Tadpole app and accounted for all the children before leaving the classroom to transition to the playground. According to S1, S2 was at the end of the line and was supposed to ensure all the children transitioned outside of the classroom before closing the classroom door. Usually, S1 will conduct another count when the class completed the transition into the playground but there was a change in schedule so another preschool classroom was utilizing the playground and there were many children present. S1 completed another face-to-name count at approximately 11:45am and was not able to locate C1 on the playground. The Admin team was immediately informed and S3 located C1 alone in the restroom of the Birch classroom

Based on the information gathered from LPA interviews conducted with 3 staffs on 09/27/2023 and record review of facility incident report on 09/25/2023, the preponderance of evidence standard has been met, therefore the above allegation staff did not provide day care child adequate supervision, resulting in child being found in the facility bathroom unsupervised is found to be SUBSTANTIATED. The following deficiency was cited during the case management visit on 09/27/2023, in accordance with California Code of Regulations, Title 22, Division 12, Section 101229(a)(1) Responsibility for Providing Care and Supervision.

Appeal Rights and deficiency were explained. The Director 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 Director Krista Bartolome.

(End of Report)

SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Nguyen K Tran
LICENSING EVALUATOR SIGNATURE:	DATE: 10/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2023

LIC9099 (FAS) - (06/04)

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