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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 300603868
Report Date: 07/18/2024
Date Signed: 07/18/2024 02:05:22 PM

Document Has Been Signed on 07/18/2024 02:05 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:FULLERTON COLLEGE CHILD DEVELOPMENT LABORATORY SCHFACILITY NUMBER:
300603868
ADMINISTRATOR/
DIRECTOR:		MARIETTA GILLIARDFACILITY TYPE:
850
ADDRESS:321 E. CHAPMAN AVE.TELEPHONE:
(714) 992-7070
CITY:FULLERTONSTATE: CAZIP CODE:
92832
CAPACITY: 60TOTAL ENROLLED CHILDREN: 60CENSUS: DATE:
07/18/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:30 AM
MET WITH:Director, Marietta GilliardTIME VISIT/
INSPECTION COMPLETED:
02:30 PM
NARRATIVE
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On 7/18/24 at 8:30am, Licensing Program Analyst (LPA) Sarah Garcia conducted an unannounced case management- visit in regard to a self-reported incident reported on 6/26/2024. Upon arrival, LPA met with Director, Marietta Gilliard. LPA informed director about the purpose of the visit and conducted a walk through of the facility. LPA observed 28 preschool children with 7 staff. A review of staff criminal clearance records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

On 6/26/24 a self-reported Unusual Incident Report (UIR) was filed with the Licensing Office. The facility reported C1 was found in Room 1, by S1 unaccompanied by a teacher while all classrooms were outside. Between 11:45am-11:50am, they left the yard and went into classroom 1 by themselves. S2 and S3 provided statements saying they saw him walking up the ramp and thought C1 was going with S4 to the bathroom. C1 walked past S4 and went to the room 1 by himself. There were 25 children on the yard 4 teachers, 1 in the bathroom with S4. Per director, there are no cameras on the premises.

During today’s visit, LPA obtained sign in/out sheets from 6/25/24, staff statements, facility plan of action, policy handbook, LIC 624, interviewed 3 staff and director. Based on interviews, evidence provided, inspection physical plant of the site and and investigation, the information revealed lack of supervision. Per staff and director interviews, on 6/25/24 C1 walked from the outdoor area to Room 1 and was left unsupervised for approximately 5 minutes. S1 found C1 at around 11:50am. According to Title 22, California Code of Regulations, Section 3, Chapter 4, (1) Type A deficiency will be cited today. See attached LIC 809D.


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SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Sarah Garcia
LICENSING EVALUATOR SIGNATURE: DATE: 07/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/18/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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Document Has Been Signed on 07/18/2024 02:05 PM - It Cannot Be Edited


Created By: Sarah Garcia On 07/18/2024 at 11:41 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: FULLERTON COLLEGE CHILD DEVELOPMENT LABORATORY SCH
FACILITY NUMBER: 300603868

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/18/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/22/2024
Section Cited
CCR
101229(a)(1)

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101229 Responsibility for Providing Care and Supervision
"(a) The licensee shall provide care and supervision....
(1) No child(ren) shall be left without the supervision of a teacher at any time..."This requirement was not met as evidenced by:
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Director agreed to conduct a staff meeting, discuss supervision, and view video, write down what they learned. Director agreed to submit replies, training agenda, and staff sign in sheet to LPA email sarah.garcia@dss.ca.gov by 5pm on 7/22/2024.
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Based on interviews and record review, Staff 1 (S1) found Child 1 (C1) unsupervised in Room 1. C1 did not have care and supervision for approximately 5 minutes. This is an immediate risk to the health, safety risk to chidlren in care.
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a.) Supervising Children in Child Care Centers- California Child Care Licensing- ccld.childcarevideos.org. LPA discussed the importance of walking around and constant name to face.

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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:Patricia Magana
LICENSING EVALUATOR NAME:Sarah Garcia
LICENSING EVALUATOR SIGNATURE:
DATE: 07/18/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/18/2024


LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: FULLERTON COLLEGE CHILD DEVELOPMENT LABORATORY SCH
FACILITY NUMBER: 300603868
VISIT DATE: 07/18/2024
NARRATIVE
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LPA Garcia informed director, Marietta Gilliard that this report dated 7/18/2024 document(s) (1) Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, and personal rights to the children in care. Also, LPA Garcia informed director to provide a copy of this licensing report dated 7/18/2024 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months form the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224) or other written statement must be kept in the child's file for verification.

Exit interview was conducted with Director. Appeal rights were discussed and provided to director. The Notice of Site Visit was posted. 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.

SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Sarah Garcia
LICENSING EVALUATOR SIGNATURE:

DATE: 07/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2024
LIC809 (FAS) - (06/04)
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