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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306001333
Report Date: 06/29/2022
Date Signed: 06/29/2022 10:51:12 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, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/10/2022 and conducted by Evaluator Charmaine Linley
PUBLIC
COMPLAINT CONTROL NUMBER: 22-CR-20220310154500
FACILITY NAME:SOUTH COAST CHILDRENS SOCIETY-CALADIUMFACILITY NUMBER:
306001333
ADMINISTRATOR:AMY MORRFACILITY TYPE:
733
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:6CENSUS: 2DATE:
06/29/2022
UNANNOUNCEDTIME BEGAN:
09:55 AM
MET WITH:Staci Tornquist, Program DirectorTIME COMPLETED:
11:00 AM
ALLEGATION(S):
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Unqualified adults caring for children.
INVESTIGATION FINDINGS:
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On June 29, 2022, at 9:55 am, Licensing Program Analyst (LPA) Charmaine Linley conducted an unannounced visit to the facility to deliver the findings of the complaint investigation for the above allegation. LPA met with Staci Tornquist, Program Director. Licensing Program Analyst (LPA) Charmaine Linley inspected the facility on 03/17/2022 at 3:00 PM. No deficiencies were observed during the inspection. LPA Linley obtained and reviewed the following documents: Special Incident Reports and C1's Needs and Services Plan. Special Investigator Hector Quintanar of the Community Care Licensing (CCL) Investigation Branch Bureau conducted interviews with seven Staff (S1 – S7) and Client #1 (C1), and a School Psychologist. In addition, Investigator Quintanar obtained and reviewed the following documents: Facility Binder Logs, Urgent Care Referral form, Hospital Medical Forms, Text messages, and Photos (2) of C1's finger.
On March 10, 2022, Community Care Licensing (CCL) received an allegation that unqualified adults are
caring for children. It was reported that staff did not receive training in working with the clients and
***CONTINUED ON NEXT PAGE
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Ann ValenzuelaTELEPHONE: (951) -782-4968
LICENSING EVALUATOR NAME: Charmaine LinleyTELEPHONE: 951-202-1850
LICENSING EVALUATOR SIGNATURE:

DATE: 06/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2022
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 7
Control Number 22-CR-20220310154500
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: SOUTH COAST CHILDRENS SOCIETY-CALADIUM
FACILITY NUMBER: 306001333
VISIT DATE: 06/29/2022
NARRATIVE
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and specifically for the specialized population. Confidential interviews revealed that training is not provided for the specialized population of clients placed at the facility; the lack of staff training resulted in staff overstimulating the C1 and staff were not able to fully understand the needs of the C1. Review of the facility Program Statement indicated that staff are to be trained initially during the new hire process and annually regarding working with specialized populations. Facility could not provide documentation for staff training.

Based on confidential interviews and record review of the facility’s program statement, the preponderance of evidence standard has been met regarding the allegation that unqualified adults are caring for children is substantiated. This poses a potential Health, Safety, or Personal Rights risk to C1 in care, the facility will be cited for violating Interim Licensing Standards, STRTP Article 6, 87065.1(a)(1)(C). Supervision, Evaluation, and Training Requirements.

An exit interview was conducted and a copy of this report, along with the appeal rights were explained and provided to Staci Tornquist, Program Director.
SUPERVISOR'S NAME: Ann ValenzuelaTELEPHONE: (951) -782-4968
LICENSING EVALUATOR NAME: Charmaine LinleyTELEPHONE: 951-202-1850
LICENSING EVALUATOR SIGNATURE:

DATE: 06/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 7
Control Number 22-CR-20220310154500
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: SOUTH COAST CHILDRENS SOCIETY-CALADIUM
FACILITY NUMBER: 306001333
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/29/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/13/2022
Section Cited
ILS
87065.1(a)(1)(C).
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Supervision, Evaluation, and Training Requirements: Licensee shall develop, maintain and implement a written plan for the supervision, evaluation, and training of staff...the plan shall do all of the
following….. provide staff with the
knowledge, skills, and support to ensure
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Per Administrator:
Training documents will be made readiliy available to Community Care Licensing at the facilities via Supervisor or Administrator. Traning documents for S1, S4, S6, S7 will be sent via email to LPA Linley by 07/13/22 at 4:59 pm.
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the health and safety of children in care and meet the individualized needs of children and families served. This requirement is not met as evidenced by: The facility did not provide training records to LPA Linley for S1, S4, S6, and S7. Based on confidential interviews and lack of training records for review
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Type B
07/13/2022
Section Cited
ILS
87065.1(a)(1)(C).
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for S1, S4, S6, and S7, the facility did not
provide staff with the knowledge, skills, and support to ensure the health and safety of children in care and meet the individualized needs of children and families served. This poses a potential Health, Safety, or Personal Rights risk to C1 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.
SUPERVISOR'S NAME: Ann ValenzuelaTELEPHONE: (951) -782-4968
LICENSING EVALUATOR NAME: Charmaine LinleyTELEPHONE: 951-202-1850
LICENSING EVALUATOR SIGNATURE:

DATE: 06/29/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 7
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/10/2022 and conducted by Evaluator Charmaine Linley
PUBLIC
COMPLAINT CONTROL NUMBER: 22-CR-20220310154500

FACILITY NAME:SOUTH COAST CHILDRENS SOCIETY-CALADIUMFACILITY NUMBER:
306001333
ADMINISTRATOR:AMY MORRFACILITY TYPE:
733
ADDRESS:9091 CALADIUM AVENUETELEPHONE:
(714) 841-7602
CITY:FOUNTAIN VALLEYSTATE: CAZIP CODE:
92708
CAPACITY:6CENSUS: 2DATE:
06/29/2022
UNANNOUNCEDTIME BEGAN:
09:55 AM
MET WITH:Staci Tornquist, Program Director TIME COMPLETED:
11:00 AM
ALLEGATION(S):
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2
3
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5
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7
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9
Staff did not seek medical attention in a timely manner.
INVESTIGATION FINDINGS:
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On June 29, 2022, at 9:55 am, Licensing Program Analyst (LPA) Charmaine Linley conducted an unannounced visit to the facility to deliver the findings of the complaint investigation for the above allegation. LPA met with Staci Tornquist, Program Director.. Licensing Program Analyst (LPA) Charmaine Linley inspected the facility on 03/17/2022 at 3:00 PM. No deficiencies were observed during the inspection. LPA Linley obtained and reviewed the following documents: Special Incident Reports and C1's Needs and Services Plan. Special Investigator Hector Quintanar of the Community Care Licensing’s (CCL) Investigation Branch Bureau conducted interviews with seven Staff (S1 – S7) and Client #1 (C1), and a School Psychologist. In addition, Investigator Quintanar obtained and reviewed the following documents: Facility Binder Logs, Urgent Care Referral form, Hospital Medical Forms, Text messages, and Photos (2) of C1's finger.
On March 10, 2022, Community Care Licensing (CCL) received an allegation that staff did not seek medical attention in a timely manner. It was reported that C1 caught the tip of their finger in the garage door and the tip of their finger was cut off, and that C1’s finger became infected and C1 returned to the hospital ***CONTINUED ON NEXT PAGE
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Ann ValenzuelaTELEPHONE: (951) -782-4968
LICENSING EVALUATOR NAME: Charmaine LinleyTELEPHONE: 951-202-1850
LICENSING EVALUATOR SIGNATURE:

DATE: 06/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 7
Control Number 22-CR-20220310154500
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: SOUTH COAST CHILDRENS SOCIETY-CALADIUM
FACILITY NUMBER: 306001333
VISIT DATE: 06/29/2022
NARRATIVE
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approximately two weeks later due to an infection. Based on confidential interviews, initial medical attention was sought in a timely manner after C1 injured their finger; staff transported C1 to the emergency room within one hour of the injury. Confidential interviews revealed that two weeks later C1’s finger was infected, and C1 was prescribed an antibiotic. Supporting interviews revealed that staff observed that C1’s finger smelled and looked infected when the bandages were taken off and changed at the facility. There is no account to when the infection occurred.

Based on confidential interviews, the allegation that staff did not seek medical attention in a timely manner may have occurred, however, is not supported or proven by evidence. Therefore, the allegation is unsubstantiated at this time.

An exit interview was conducted and a copy of this report, along with the appeal rights were explained and provided to Staci Tornquist, Program Director.
SUPERVISOR'S NAME: Ann ValenzuelaTELEPHONE: (951) -782-4968
LICENSING EVALUATOR NAME: Charmaine LinleyTELEPHONE: 951-202-1850
LICENSING EVALUATOR SIGNATURE:

DATE: 06/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2022
LIC9099 (FAS) - (06/04)
Page: 5 of 7