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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304371246
Report Date: 01/28/2022
Date Signed: 01/28/2022 01:05:05 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
11/01/2021 and conducted by Evaluator Pat Rivas
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20211101120015
FACILITY NAME:MARCO POLO CHILDREN'S SCHOOLFACILITY NUMBER:
304371246
ADMINISTRATOR:GERMAIN, STACYFACILITY TYPE:
850
ADDRESS:17861 VON KARMAN AVENUETELEPHONE:
(949) 333-5388
CITY:IRVINESTATE: CAZIP CODE:
92614
CAPACITY:168CENSUS: 104DATE:
01/28/2022
UNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Stacy Germain, DirectorTIME COMPLETED:
01:15 PM
ALLEGATION(S):
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Staff not providing a safe environment for daycare children.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) P Rivas conducted an unannounced complaint visit to render findings regarding above allegation. During today’s visit LPA toured all rooms and noted cabinets have been repaired and are now stacked and anchored against the walls in classrooms or placed side by side on floor and anchored. The following was noted for census; Jr. Preschool Rm had 14 children 3 teachers; All other 9 rooms had 2 teachers in each room. Sailor English(Toddlers) 8 children; Jr. Pre K-Sailor English had 7 children; Toddler Mandarin had 10 children;Toddler Chinese had 7 children; English Pre-school had 16 children; Mandarin Preschool had 11 children; Pre K English had 3 children; Pre-k Mandarin had 14 children; Tk had 14 children.

A review of the Facility Personnel Report Summary on this date indicated all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

cont. 9099(c)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Rina Lopez
LICENSING EVALUATOR NAME: Pat Rivas
LICENSING EVALUATOR SIGNATURE:

DATE: 01/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2022
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 3
Control Number 06-CC-20211101120015
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: MARCO POLO CHILDREN'S SCHOOL
FACILITY NUMBER: 304371246
VISIT DATE: 01/28/2022
NARRATIVE
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The investigation consisted of; physical plant tour, interview with two staff including the Director, review of records.

The investigation revealed the following; On 10/29/21 before school opened a cabinet fell from the wall down to the floor in Toddler Mandarin classroom. Director reported there were no children in the facility at the time the incident occurred. However, the area where cabinet fell, is used by children during hours of operation. Per Director’s statement no one was injured.

LPA reviewed copy of timeline, proof that original cabinets were installed by a contractor. Director completed an Action Plan that included but not limited to; immediate removal and inspection of all cabinets by a contractor; scheduled a Townhall Meeting with all parents

Based on LPAs observations and interviews which were conducted record review(s), the preponderance of evidence standard has been met, therefore the above allegation is found to be substantiated. California Code of Regulations, Title 22, Division (12) and Chapter (1) are being cited on the attached LIC 9099D.

An exit interview was conducted with director. Appeal Rights were explained. The Director was provided a copy of appeal rights (LIC 9058) 01/16) 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.

The Notice of Site Visit was given and discussed it must be posted as required by H & S Code Sec. 1596.817. Notice of Site Visit must be posted for 30 consecutive days. Failure to post will result in civil penalties of $100.00

SUPERVISORS NAME: Rina Lopez
LICENSING EVALUATOR NAME: Pat Rivas
LICENSING EVALUATOR SIGNATURE:

DATE: 01/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 06-CC-20211101120015
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: MARCO POLO CHILDREN'S SCHOOL
FACILITY NUMBER: 304371246
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/28/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/04/2022
Section Cited
CCR
101238(a)
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Buildings and Grounds The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors. This requirement was not met as evidenced by interview with 3 staff who indicated a cabinet fell in Mandarin Toddler classroom on 10/29/21 before the
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Director was pro-active and immediately hired a contractor to inspect all cabinets which were removed for inspection. After Townhall meeting it was determined cabinets would be anchored and stacked. During today's visit LPA observed cabinets in rooms and most were stacked and anchored, others were set side by side and anchored.; cleared during visit
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facility was open.This poses a potential danger to children 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: Rina Lopez
LICENSING EVALUATOR NAME: Pat Rivas
LICENSING EVALUATOR SIGNATURE:

DATE: 01/28/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 3