<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304371214
Report Date: 06/11/2024
Date Signed: 06/11/2024 12:41:15 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
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: 58DATE:
06/11/2024
UNANNOUNCEDTIME BEGAN:
10:46 AM
MET WITH:Director Krista BartolomeTIME COMPLETED:
11:45 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff served child food that child had an allergy to
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 06/11/2024, Licensing Program Analyst (LPA) Romy Castanon made an unannounced visit to the facility to deliver findings of a complaint that was received at the Orange County Regional Child Care Program Office. 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 58 children and 9 staff.

A review of the Facility Personnel Report Summary on 06/11/2024 indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

On 04/22/2024, the Regional Office received a complaint report alleging staff served child food that child had an allergy to. Complaint stated on 08/10/2023, the Camellia Room held a celebration where Child #1 (C1) was served a pastry with nuts and had an allergic reaction. LPA interviewed Reporting Party (RP) who stated the facility is a nut-free facility and the pastry label warned nuts as an ingredient. (Continue to page 2)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Romelia M Castanon
LICENSING EVALUATOR SIGNATURE:

DATE: 06/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/11/2024
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: 06/11/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Page 2
RP stated C1 ingested the pastry and complained of stomach pain. RP stated C1’s eyes were purple. RP stated the facility did not report the incident to licensing or C1’s parents. RP stated C1 attended the next day on 08/11/2023 and their eyes were still purple and having stomach issues.

LPA conducted a visit on 02/23/2024 and interviewed 5 staff members. 5 out of 5 staff stated they were aware of all daycare children’s allergies, including C1’s. 5 out of 5 staff stated the facility is a nut free school and list are provided to staff and posted in the classrooms. 5 out of 5 staff were able to reiterate allergy procedures in case of a reaction. 5 out of 5 staff stated they did not have any knowledge of incident regarding an allergic reaction involving any daycare children. During interview with Staff #2 (S2), they disclosed a potential incident with C1. S2 states they recall the celebration on 08/10/2023 and C1 did not consume the pastry with nuts. S2 stated the pastry was served on a plate in front of C1. Staff realized that C1 should not have been served that pastry and removed it. S2 stated C1 did not touch the pastry but C1 was monitored the rest of the day. S2 stated C1 completed their day and there were no signs of an allergic reaction or symptoms.

LPA reviewed C1's food allergy care plan that determined they are anaphylactic to nuts. LPA was unable to obtain any incident reports for allergy exposure on 08/10/2023 or verify C1’s parents were notified of the exposure on 08/10/2024. LPA interview C1's Parent #1 (P1) who stated there have been no reports of allergic exposures or reactions at the facility.

LPA interviewed four (4) children including C1. There were no disclosures made to LPA. LPA interviewed three (3) parents. Parents did not provide any information pertinent to allegations of this complaint.

Based on LPA’s interviews and record review, the preponderance of evidence standard has been met, therefore the above allegation staff served child food that child had an allergy to is substantiated. California Code of Regulations, Title 22, Division 12, 101227 Food Services 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.

Upon receipt, Director Krista Bartolome shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. Licensee shall have LIC9224 (Acknowledgement of Receipt) signed and kept in each child's file. (End of Report)

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

DATE: 06/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/11/2024
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: 06/11/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/12/2024
Section Cited
CCR
101227(7)(B)
1
2
3
4
5
6
7
101227(7)(B) Food Services (B) A child shall not be served any food to which the child's record indicates he/she has an allergy. This requirement was not met as evicenced by:
1
2
3
4
5
6
7
Director stated the food is given to the front desk for initial inspection, then ptovided to the classroom. Upon inspection the food items must have an ingredient list. Director will conduct a meeting regarding allergy procedures on 06/11/2024 and submit a signed attendance sheet to LPA by POC date.
8
9
10
11
12
13
14
Based on LPA's interviews and record review, the facility did not follow food allergy care plan. C1 was served pastry with nuts, did not utilize epinephren medication or notify C1's parents of exposure. This is an immediate health, safety or personal rights risk to persons in care.
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: 06/11/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/11/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3