304371500-9-13-2022-06-CC-JHAN-CJHU62-20220922151737

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 304371500
Report Date: 09/13/2022
Date Signed: 09/13/2022 04:56:05 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
09/06/2022 and conducted by Evaluator Dean Thompson

PUBLIC

COMPLAINT CONTROL NUMBER: 06-CC-20220906111142

FACILITY NAME:	KIDDIE ACADEMY OF MISSION VIEJO		FACILITY NUMBER:	304371500
ADMINISTRATOR:	ESCOBEDO, CATHERINE		FACILITY TYPE:	830
ADDRESS:	25521 MUIRLANDS BLVD.		TELEPHONE:	(949) 380-6868
CITY:	MISSION VIEJO	STATE: CA	ZIP CODE:	92691
CAPACITY:	20	CENSUS: 18	DATE:	09/13/2022
		UNANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Catherine Escobedo		TIME COMPLETED:	05:15 PM

ALLEGATION(S):

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Staff are not following a daycare child's dietary plan while in care

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPA) Thompson conducted an unannounced complaint investigation. Upon arrival LPA met with Director Catherine Escobedo to initiate, investigate, and to deliver complaint findings. At the time of visit, LPA observed a total of 18 children and 5 staff; 7 Infants in the infant room with 2 staff, 11 toddlers in the toddler room with 3 staff. Facility was operating within ratio.

A review of staff records on this date indicated that all facility staff or other individuals who required caregiver background checks have received criminal record and child abuse index clearances or exemptions.

The Department received a complaint on 9/06/2022 alleging staff are not following a daycare child's dietary plan while in care.

Continue to page 2.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Judy Hanson	TELEPHONE: (714) 795-0415
LICENSING EVALUATOR NAME: Dean Thompson	TELEPHONE: (714) 287-0708
LICENSING EVALUATOR SIGNATURE:	DATE: 09/13/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2022

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-20220906111142

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: KIDDIE ACADEMY OF MISSION VIEJO	FACILITY NUMBER: 304371500
	VISIT DATE: 09/13/2022

NARRATIVE

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The complainant party (CP) reported Staff are not following a daycare child's dietary plan while in care.

During the investigation LPA Thompson interviewed complaining party, Director, and 4 staff members. LPA reviewed the children’s roster, five children files, allergy list, diet restrictions letters, and food daily reports.

During an interview on 9/13/2022, the Director (S5) stated, children in care have an allergy list posted on a clipboard inside their classrooms. LPA observed the allergy list and and it has the name and picture of each child with a list of their allergy and diet restrictions.

During staff interviews, it was determined all teachers and assistants inside the classrooms have access to the allergy list. Staff also stated they all have access to the food daily report and are able to edit and make changes to the food report to reflect what the child was given to eat when in care. Some staff also stated they have witness children taking food from other childrens plates. One staff stated witnessing a staff accidentally given food to a child they weren’t supposed to have but later taken away.

During file reviews, LPA reviewed the diet restrictions letters that is given to parents to fill out and return back to the facility. Child #1 (C1) file states No Dairy or Dairy Containing Foods. (C1) allergy/ diet restrictions reads Dairy as an Allergy/Reaction. LPA observed the daily food reports for (C1) that shows (C1) was given dairy products on multiple occasions.

Based on LPA facility inspection, observation, interviews conducted with complainant party, director, staff members, and records reviewed it has been determined that C1 dietary plan was not being followed. Therefore, the preponderance of evidence standard has been met, the allegations are found to be Substantiated. California Code of Regulations, Title 22, 101427(c) Infant Care Food Service is being cited on the attached LIC 9099D.

Exit interview conducted and report was reviewed with the Director Catherine Escobedo. A notice of site visit was given and must remain posted for 30 days.

Appeal Rights and deficiencies were discussed. The 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.

SUPERVISOR'S NAME: Judy Hanson	TELEPHONE: (714) 795-0415
LICENSING EVALUATOR NAME: Dean Thompson	TELEPHONE: (714) 287-0708
LICENSING EVALUATOR SIGNATURE:	DATE: 09/13/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2022

LIC9099 (FAS) - (06/04)

Page: 3 of 3

Control Number 06-CC-20220906111142

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: KIDDIE ACADEMY OF MISSION VIEJO	FACILITY NUMBER: 304371500
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/13/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 09/27/2022 Section Cited CCR 101427(c)	1 2 3 4 5 6 7	101427 Infant Care Food Service (c) The infant shall be fed in accordance with the individual plan.	1 2 3 4 5 6 7	Director will review current staff procedures in regard to infant food services with infant staff and provide a list of staff trained as well as information reviewed. Director will submit proof by email to LPA by the POC due date 9/27/22.
	8 9 10 11 12 13 14	Based on observation, interviews, and record review staff failed to follow the child dietary food plan. This poses a potential health risk to the children 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.

SUPERVISOR'S NAME: Judy Hanson	TELEPHONE: (714) 795-0415
LICENSING EVALUATOR NAME: Dean Thompson	TELEPHONE: (714) 287-0708
LICENSING EVALUATOR SIGNATURE:	DATE: 09/13/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2022

LIC9099 (FAS) - (06/04)

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