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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304371586
Report Date: 06/20/2023
Date Signed: 06/20/2023 10:35:14 AM

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
05/31/2023 and conducted by Evaluator Nguyen K Tran
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20230531123228
FACILITY NAME:KIDDIE ACADEMY OF BUENA PARKFACILITY NUMBER:
304371586
ADMINISTRATOR:BARBA, KARLAFACILITY TYPE:
830
ADDRESS:7501 COMMONWEALTH AVENUETELEPHONE:
(714) 752-6294
CITY:BUENA PARKSTATE: CAZIP CODE:
90621
CAPACITY:20CENSUS: 6DATE:
06/20/2023
UNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Karla Barba, DirectorTIME COMPLETED:
11:00 AM
ALLEGATION(S):
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Infant is not accorded dignity in their relationship with staff.
Staff handle infants in a rough manner.
INVESTIGATION FINDINGS:
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On 06/20/2023, Licensing Program Analyst (LPA) Tran conducted a subsequent investigation to deliver the findings regarding the above complaint allegations. LPA Tran met with Director Karla Barba. A toured the facility was conducted, and a census was taken. Observed at the time of the visit was a total of 2 infants and 1 staff in the infant classroom and 4 toddlers and 1 staff in the toddler classroom.

A review of the Facility Personnel Report Summary on 06/20/2023indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

On 05/31/2022, the Regional office received a complaint alleging, infant is not accorded dignity in their relationship with staff, staff handle infants in a rough manner. Reporting Party (RP) provided 2 video clips, in which RP claimed to observe staff #5 handling the children in care, in a rough manner.
(Continue next page)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Rina Lopez
LICENSING EVALUATOR NAME: Nguyen K Tran
LICENSING EVALUATOR SIGNATURE:

DATE: 06/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2023
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 6
Control Number 06-CC-20230531123228
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: KIDDIE ACADEMY OF BUENA PARK
FACILITY NUMBER: 304371586
VISIT DATE: 06/20/2023
NARRATIVE
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(Page 2 of Report)

During the investigation, LPA observed staff's interaction with the infants, interviewed 6 staff members and Director, reviewed facility roster and children's and staff files.

On 06/01/2023, LPA Tran conducted the initial 10-day investigation and interviewed 7 staff members including the Director. All interviewed staff denied of witnessing any staff handling the infants in a rough manner and not treating the infants accorded dignity in their relationship with staff. Director shared that it was just reported to the Director, on 06/01/2023, that S5 was observed on camera, handling a toddler in a rough manner. Director had a plan to review the camera footage and meet with S5 to address the concern. During interview on 06/20/2023, Director shared that Director had followed up and reviewed the camera footage on an incident occurred on 06/01/2023. Director disclosed that Director observed S5 picked child #3 (C3) from child's cot, in a rough manner, while C3 was half asleep and placed C3 into a chair. S5 was observed to talked down to C3. Facility's management team met with S5 to address the concern and decided to terminate S5's employment due to concern about S5's behavior not meeting facility's expectations.

During record review, LPA Tran reviewed the camera footage and observed S5 providing care for child #2 (C2) in a rough manner. In the footage, C2 was observed crying and had running nose. S5 was observed providing care for C2 and wiped C2's nose in a rough manner. LPA could not determined what was said because there was no audio in the footage, however, S5 was observed to be upset and was saying something as S5 was walking away from C2, while C2 continued to cry inconsolably and appeared to be choking.

Based on the information LPA gathered from interviews with 7 staff on 06/01/2023 and with Director on 06/20/2023, and record review of the camera footage, the preponderance of evidence standard has been met, therefore the above allegations about infant is not accorded dignity in their relationship with staff, and staff handle infants in a rough manner is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 12 & Chapter 1, 101223(a)(1) Personal Rights is being cited on the attached LIC9099D.

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SUPERVISORS NAME: Rina Lopez
LICENSING EVALUATOR NAME: Nguyen K Tran
LICENSING EVALUATOR SIGNATURE:

DATE: 06/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 6
Control Number 06-CC-20230531123228
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: KIDDIE ACADEMY OF BUENA PARK
FACILITY NUMBER: 304371586
VISIT DATE: 06/20/2023
NARRATIVE
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(Page 3 of Report)



Appeal Rights and deficiency were discussed. The facility representative 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. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with Director Karla Barba.

(End of Report)
SUPERVISORS NAME: Rina Lopez
LICENSING EVALUATOR NAME: Nguyen K Tran
LICENSING EVALUATOR SIGNATURE:

DATE: 06/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 6
Control Number 06-CC-20230531123228
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: KIDDIE ACADEMY OF BUENA PARK
FACILITY NUMBER: 304371586
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/20/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/27/2023
Section Cited
CCR
101223(a)(1)
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101223 Personal Rights (a) The licensee shall ensure that each child is accorded the following personal rights: (1) To be accorded dignity in his/her personal relationships with staff and other persons.
This requirement is not met evidenced by:
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Director stated that management team has met with S5 and addressed concern about S5's behavior and had taken action to terminate S5's employment. Director stated that she would provide proof of facility staff's retraining regarding personal rights to LPA by due date.
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Based on interview and record review, S5 was observed handling child C2 and C3 in a rough manner, which posed potential risks to the health, safety and personal rights to the 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: Nguyen K Tran
LICENSING EVALUATOR SIGNATURE:

DATE: 06/20/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2023
LIC9099 (FAS) - (06/04)
Page: 4 of 6
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
05/31/2023 and conducted by Evaluator Nguyen K Tran
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20230531123228

FACILITY NAME:KIDDIE ACADEMY OF BUENA PARKFACILITY NUMBER:
304371586
ADMINISTRATOR:BARBA, KARLAFACILITY TYPE:
830
ADDRESS:7501 COMMONWEALTH AVENUETELEPHONE:
(714) 752-6294
CITY:BUENA PARKSTATE: CAZIP CODE:
90621
CAPACITY:20CENSUS: 6DATE:
06/20/2023
UNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Karla Barba, DirectorTIME COMPLETED:
11:00 AM
ALLEGATION(S):
1
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9
Staff did not provide infant with a snack
INVESTIGATION FINDINGS:
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On 06/20/2023, Licensing Program Analyst (LPA) Tran conducted a subsequent investigation to deliver the findings regarding the above complaint allegation. LPA Tran met with Director Karla Barba. A toured the facility was conducted, and a census was taken. Observed at the time of the visit was a total of 2 infants and 1 staff in the infant classroom and 4 toddlers and 1 staff in the toddler classroom.
A review of the Facility Personnel Report Summary on 06/20/2023 indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

On 05/31/2022, the Regional office received a complaint alleging, staff did not provide infant with a snack. Reporting Party claimed to observe staff #5 provided snacks to all of the children in the room except 1 child in a video footage, however, RP was not able to provide the footage nor able to provide specifics on the incident.
(Continue next page)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Rina Lopez
LICENSING EVALUATOR NAME: Nguyen K Tran
LICENSING EVALUATOR SIGNATURE:

DATE: 06/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 5 of 6
Control Number 06-CC-20230531123228
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: KIDDIE ACADEMY OF BUENA PARK
FACILITY NUMBER: 304371586
VISIT DATE: 06/20/2023
NARRATIVE
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(Page 2 of Report)

During the investigation, LPA interviewed 6 staff members and Director, reviewed facility roster and children's and staff files.

During interviews on 06/01/2023, all interviewed staff denied of witnessing any staff not providing any child snacks or hearing any concern about children were not provided snacks.

During record review, LPA Tran reviewed the children's file and facility's meal counts which revealed that all present children were provided breakfast, lunch and snacks for the month of May 2023.

Based on the interviews conducted with staff 06/01/2023 and record review of facility's meal counts, there is insufficient evidence to corroborate the allegation that staff did not provide infant with a snack. Although the allegation may have happened or are valid, there is not a preponderance of evidence to prove that staff did not provide infant with a snack did or did not occur, therefore the allegation that staff did not provide infant with a snack is UNSUBSTANTIATED.

Appeal Rights were discussed. The facility representative 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. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with Director Karla Barba.

(End of Report)
SUPERVISORS NAME: Rina Lopez
LICENSING EVALUATOR NAME: Nguyen K Tran
LICENSING EVALUATOR SIGNATURE:

DATE: 06/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2023
LIC9099 (FAS) - (06/04)
Page: 6 of 6