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

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304371253
Report Date: 06/11/2024
Date Signed: 06/11/2024 03:36:23 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 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 Archibaldo Silva
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20240422144549
FACILITY NAME:APPLE TREE PRESCHOOL & KINDERGARTENFACILITY NUMBER:
304371253
ADMINISTRATOR:PERANCULLO, MARBENFACILITY TYPE:
830
ADDRESS:2211 WEST WOODLEY AVENUETELEPHONE:
(714) 772-1005
CITY:ANAHEIMSTATE: CAZIP CODE:
92801
CAPACITY:30CENSUS: 24DATE:
06/11/2024
UNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Ishara SilvaTIME COMPLETED:
03:45 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
101427(b)(4) Infant Care Food Service
101223(a)(2) Personal Rights
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 6/11/2024 Licensing Program Analyst (LPA) A. Silva conducted an unannounced complaint investigation inspection. This is a continuation of the investigation initiated on 5/1/2024. Upon arrival, the LPA met with Director Ishara Silva and informed the director of the purpose of the visit. A review of the Facility Personnel Report Summary shows all facility staff or individuals who require caregiver background checks have received a criminal record clearance and a child abuse index clearance or an exemption clearance. The census at the time of the visit was 24 (six infants and 18 toddlers).

The Department received a complaint on 4/22/2024 alleging that staff did not meet an infant's feeding plan, staff did not prevent the infant from eating restricted food, and staff's failure to adhere to the infant’s feeding plan resulted in diarrhea and diaper rash.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Archibaldo Silva
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 4
Control Number 06-CC-20240422144549
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: APPLE TREE PRESCHOOL & KINDERGARTEN
FACILITY NUMBER: 304371253
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
On 4/23/2024, the LPA called the Reporting Party (PR) requesting additional details. The RP reaffirmed the allegations. On 5/15/24, the LPA followed up with the RP. The RP affirmed that Child 1 (C1) had been drinking the same milk since before enrollment at the childcare center without digestive issues. The digestive issues started after C1 began attending the daycare. C1 continues to drink the same milk.

Allegation: Staff did not meet an infant's feeding plan.
On 5/1/2024, the LPA interviewed six staff including area director Margarita Calero who provided a blank copy of the infant feeding plan template. When shown a copy of the school’s infant feeding plan, three out of four staff who work with infants did not recognize the school’s infant feeding plan template. One staff stated that the administration doesn’t give them copies of the infant's individual feeding plan and that they “just give them all the same amount and the same kind of food, except when the baby has an allergy.” Per CCR 101427(b)(3)(G), infant centers must have an individual feeding plan for each infant and the plan must be updated as necessary to reflect changes. The infant feeding plan in file did not reflect the updated information.

Allegation: Staff did not prevent the infant from eating restricted food.
The LPA asked staff about C1 gaining access to restricted foods that may cause C1 diarrhea. One staff disclosed that “other friends were throwing food at C1” so C1 got a hold of school food. The same staff also said they put C1 next to other infants and C1 started “grabbing the other kids’ food” until [C1] was placed in another chair. The staff said that when C1 got a hold of school food, they wiped the infant’s hands taking the food away. The rest of the staff denied the allegations or said they did not witness the incident.

Allegation: Staff's failure to adhere to the infant’s feeding plan resulted in diarrhea and diaper rash.
The LPA asked if C1 experienced diarrhea and diaper rash because of eating the restricted food. One staff said C1 experienced diarrhea “more than one time” which resulted in diaper rash. The same staff confirmed that the child was dismissed for the day after having more than two consecutive episodes of diarrhea. S1 and S4 stated that C1’s diarrhea stopped after the child left the infant room. The rest of the staff did not provide any information that could corroborate or dismiss the allegation. Under section 101427 Infant Care Food Service (b)(3)(G) There shall be an individual feeding plan for each infant. The plan shall include Food allergy and must be updated as necessary. The infant feeding plan in file was not updated to reflect the child’s dietary restrictions.
SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Archibaldo Silva
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 4
Control Number 06-CC-20240422144549
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: APPLE TREE PRESCHOOL & KINDERGARTEN
FACILITY NUMBER: 304371253
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
On 5/15/2024, the LPA called 11 parents requesting an interview. Only two parents were reached and interviewed. The two parents did not express any concerns. The rest of the parents were not reached or did not respond to the Department's request for comment.

On 4/22/2024, the LPA received records documenting conversations between staff and RP. The records state that C1 had diarrhea and at some point, was bleeding possibly due to the rash. On 5/01/24, the LPA obtained copies of the infant individual feeding plans of four children. C1’s individual feeding plan was dated September 2023. The first instance of diarrhea the LPA was able to date happened on November 1, 2023. The records show that by 11/01/23, the parties involved had been trying to track when the diarrhea happened to discover potential allergies, suggesting the issue began before November 1. The records show staff observed the bleeding on November 8.

Based on records review and interview statements, the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED. A substantiated finding means that the complaint is substantiated, and the allegations are valid.

LPA A. Silva informed Ishara Silva that this licensing report dated 6/11/2024 documents two “Type A” citations. Type A citations must be posted for 30 consecutive days during the hours that children are in care as there are immediate risks to the health, safety, or personal rights of children in care. LPA A. Silva further informed Ishara that a copy of this licensing report must be provided to parents or guardians of all clients currently enrolled by the next business day or by the next day the children are in care, a copy of this report must be provided to the parents or guardians of all newly enrolled clients for 12 months from the date of this report, and signed Acknowledgement of Receipt of Licensing Report (LIC 9224) form, or another written equivalent statement, must be placed in the child's file for verification of receipt of the report.

An exit interview was conducted with Ishara. The Notice of Site Visit was posted during the visit. The director was informed that the Notice of Site Visit must be posted for 30 consecutive days. Failure to post will result in civil penalties of $100. The director was provided a copy of their appeal rights (LIC 9058 01/16) and their signature on this form acknowledges receipt of these rights. First-level appeals should be sent to the regional manager to the address listed above.
END.
SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Archibaldo Silva
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: 3 of 4
Control Number 06-CC-20240422144549
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: APPLE TREE PRESCHOOL & KINDERGARTEN
FACILITY NUMBER: 304371253
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
101427(b)(4)
1
2
3
4
5
6
7
101427(b)(4) Infant Care Food Service
(b) There shall be an individual feeding plan for each infant. (4) The plan shall be updated … as necessary to reflect changes.

This requirement is not met as evidenced by:
1
2
3
4
5
6
7
Director stated that she will have an a training with the staff and establish a protocol so that changes in infant's feeding plans are communicated to the Director in order to update the plan in writing. The director will provide materials and attendance sheet.
8
9
10
11
12
13
14
Based on records and interview statements, the individual infant feeding plan was not updated to reflect the changes in the C1’s dietary plan, which poses/posed an immediate risk to the health of the children in care.
8
9
10
11
12
13
14
Type A
06/12/2024
Section Cited
CCR
101223(a)(2)
1
2
3
4
5
6
7
101223(a)(2) Personal Rights. The licensee shall ensure that each child is accorded the following personal rights: (2) To be accorded safe, healthful and comfortable accommodations.
This requirement is not met as evidenced by:
1
2
3
4
5
6
7
Director stated she will hold a training with staff to discuss children accomodations and provide evidence of attendance and materials.
8
9
10
11
12
13
14
Based on records and interview statements, staff stated that C1 got a hold of restricted food that caused C1 diarrhea on two or more occasions. The staff did not prevent the child from eating restricted food. This poses an immediate risk to the health of the children in care.
8
9
10
11
12
13
14
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: Archibaldo Silva
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: 4 of 4