304270065-11-19-2024-06-CC-NKTN-DC5TCU-20241220133715

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 304270065
Report Date: 11/19/2024
Date Signed: 11/19/2024 01:27:53 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
11/19/2024 and conducted by Evaluator Dean Thompson

PUBLIC

COMPLAINT CONTROL NUMBER: 06-CC-20241119091128

FACILITY NAME:	SADDLEBACK YMCA-BATHGATE CENTER		FACILITY NUMBER:	304270065
ADMINISTRATOR:	JESSICA CERVANTES		FACILITY TYPE:	840
ADDRESS:	27642 NAPOLI WAY		TELEPHONE:	(949) 363-7089
CITY:	MISSION VIEJO	STATE: CA	ZIP CODE:	92691
CAPACITY:	100	CENSUS: 0	DATE:	11/19/2024
		UNANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Allison Wong		TIME COMPLETED:	01:45 PM

ALLEGATION(S):

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Staff did not provide adequate supervision to day care child.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Thompson conducted an unannounced complaint investigation on today’s date. Upon arrival LPA met with Director Allison Wong and toured the facility. There were no children present upon arrival.

The Orange County Child Care Office received a complaint 11/19/2024, with one allegation listed above.

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

RP mentioned on 11/15/2024, a child was left alone without any supervision for approximately 10 to 15 minutes.

Continue to page 2.

Substantiated

Estimated Days of Completion:

SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Dean Thompson
LICENSING EVALUATOR SIGNATURE:	DATE: 11/19/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/19/2024

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-20241119091128

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: SADDLEBACK YMCA-BATHGATE CENTER	FACILITY NUMBER: 304270065
	VISIT DATE: 11/19/2024

NARRATIVE

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During the investigation, LPA took pictures, interviewed two staff, and obtained a copy of the Headcount and Attendance Roster.

Based on interviews, it was revealed that child (C1) was left alone on 11/15/2024, without any adult supervision inside the bathroom. C1 was left unattended for about 3 - 4 minutes until parent of child (C1) arrived. The following violation Responsibility for providing care and supervision was revealed today and is being cited in accordance with California Code of Regulations, Title 22, Division 12, Chapter 1, 101229 (a)(1). Please see the attached LIC 809D

The facility was cited on a self reported Unusual Incident Report (UIR) on 11/19/2024 for the same incident that occurred on 11/15/2024.

LPA Thompson informed Director Allison Wong that this report dated 11/19/2024, document(s) one Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPA Thompson informed Director Allison Wong to provide a copy of this licensing report dated 11/19/2024, 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 from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

Exit interview conducted and report was reviewed with Director Allison Wong. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Appeal Rights and deficiencies 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.

SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Dean Thompson
LICENSING EVALUATOR SIGNATURE:	DATE: 11/19/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/19/2024

LIC9099 (FAS) - (06/04)

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