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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304371214
Report Date: 07/10/2024
Date Signed: 07/11/2024 08:09:23 AM

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
04/22/2024 and conducted by Evaluator Romelia M Castanon
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20240422114045
FACILITY NAME:LEPORT-IRVINE SPECTRUM-NORTH CAMPUSFACILITY NUMBER:
304371214
ADMINISTRATOR:BARTOLOME, KRISTAFACILITY TYPE:
850
ADDRESS:1 TECHNOLOGY DRIVE BLDG. ATELEPHONE:
(949) 427-3968
CITY:IRVINESTATE: CAZIP CODE:
92618
CAPACITY:119CENSUS: 55DATE:
07/10/2024
UNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Director Krista BartolomeTIME COMPLETED:
01:15 PM
ALLEGATION(S):
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Reporting Requirements
INVESTIGATION FINDINGS:
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On 07/10/2024, Licensing Program Analyst (LPA) Romy Castanon made an unannounced visit to the facility to deliver findings of an additional allegation. LPA met with Director Krista Bartolome and explained the reason for today’s visit. Observed at the time of the visit was a total of 55 children and 10 staff.

A review of the Facility Personnel Report Summary on 07/10/2024 indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

During staff and parent/guardian interviews regarding a food services complaint, LPA discovered Director did not notify the Licensing Department of an unusual incident that occurred on 08/10/2023 in the Camellia Classroom. During today’s visit, Director could not provide any documentation notifying the department of the incident. (Continue to page 2)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Romelia M Castanon
LICENSING EVALUATOR SIGNATURE:

DATE: 07/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2024
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-20240422114045
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: 07/10/2024
NARRATIVE
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Page 2

Based on LPA’s interviews and record review, the preponderance of evidence standard has been met, therefore the above allegation reporting requirements is substantiated. California Code of Regulations, Title 22, Division 12, Section 101212(d)(1)(C) Reporting Requirements is being cited on the attached LIC9099D.

Exit interview was conducted with Director Krista Bartolome. The Notice of Site Visit was posted. Facility representative was informed that the Notice of Site Visit must be posted for 30 consecutive days. Failure to post will result in civil penalty of $100. Director 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.

End of Report

SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Romelia M Castanon
LICENSING EVALUATOR SIGNATURE:

DATE: 07/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 06-CC-20240422114045
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/10/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/19/2024
Section Cited
CCR
101212(d)(1)(C)
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101212(d)(1)(C) Reporting Requirements (d) Upon the occurrence…(1) Events reported shall include the following: …(C) Any unusual incident or child absence that threatens the physical or emotional health or safety of any child. This requirement was not met as evidenced by:
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Director states the facility Business Manager will create and submit unusual incident reports in the event that the Director is not at the facility. Director will submit a plan of action to the department by the POC date.
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Based on LPA's interviews and record review, Director did not notify the Licensing Department of an unusual incident that occurred on 08/10/2023 in the Camellia Classroom. This poses a potential health, safety or personal rights risk to persons in care.
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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: Patricia Magana
LICENSING EVALUATOR NAME: Romelia M Castanon
LICENSING EVALUATOR SIGNATURE:

DATE: 07/10/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3