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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304370276
Report Date: 06/08/2021
Date Signed: 06/08/2021 04:50:41 PM

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
03/23/2021 and conducted by Evaluator Jordann Nelson
COMPLAINT CONTROL NUMBER: 06-CC-20210323152648
FACILITY NAME:TUTOR TIME CHILD CARE/LEARNING CENTERFACILITY NUMBER:
304370276
ADMINISTRATOR:NICHOLS, KELSIEFACILITY TYPE:
850
ADDRESS:350 SOUTH FESTIVAL DRIVETELEPHONE:
(714) 282-8296
CITY:ANAHEIM HILLSSTATE: CAZIP CODE:
92808
CAPACITY:113CENSUS: 55DATE:
06/08/2021
UNANNOUNCEDTIME BEGAN:
04:30 PM
MET WITH:Kelsie NicholsTIME COMPLETED:
04:45 PM
ALLEGATION(S):
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Facility did not report child's injury to parent
INVESTIGATION FINDINGS:
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Tele-Inspection-COVID 19 State of Emergency

On 06/08/2021 Licensing Program Analyst (LPA) Jordann Nelson conducted an announced complaint Tele-Inspection regarding the allegation listed above with director Kelsie Nichols. The director was informed that due to COVID-19 and social distancing guidelines, the visit would be conducted via Facetime.


A review of the Facility Personnel Summary on the above date indicates that all staff have criminal background clearance check clearances and are properly associated to the center. On 03/23/2021 a complaint was filed with the Department that the facility did not report child's injury to the parent.

Continued on Pg 2
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Jordann Nelson
LICENSING EVALUATOR SIGNATURE:

DATE: 06/08/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/08/2021
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 3
Control Number 06-CC-20210323152648
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: TUTOR TIME CHILD CARE/LEARNING CENTER
FACILITY NUMBER: 304370276
VISIT DATE: 06/08/2021
NARRATIVE
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Continued from Pg 1

During the investigation, LPA Nelson observed at the day-care center during normal operating hours. The two-year-old classroom was observed during snack time on 04/14/2021. The director, assistant director, three teachers and five parents were interviewed.

Interviews conducted with five parents, one parent noticed a bruise on the child and called and asked the facility about what took place. Interviews conducted with the center director who acknowledged the parents concern and followed up with the teacher. The director informed the parent that during a class bubble activity the child fell back but did not observe any visible injuries and therefore that was why no injury was reported.

Interviews were conducted with the teachers and the director who confirmed that there was not an unusual incident report, or an ouch report generated. The director and teaching staff failed in communicating to the parent that the child in care sustained an injury. The Director and teaching staff acknowledged that when a child sustained an injury an incident report or ouch report needs to be generated.

Based on interviews and direct observation the child in care sustained an injury while in care and the facility failed to report the injury to the parent, the above allegations are found to be substantiated. California Code of regulations, Title 22, Division 12, 101226 (a) (2) Health Related Services The licensee shall immediately notify the child's authorized representative if the child becomes ill or sustains an injury more serious than a minor cut or scratch.

Exit interview was conducted with Kelsie Nichols the report was read to Director. A copy of the report along with Appeal Rights will be emailed to Licensee with a Read Receipt to acknowledge report was received. Director was asked to respond to email by copying the following, “I have read and received the Investigation Report and Appeal Rights, I acknowledge receipt.” All appeals must be in writing and received by the Licensing office within 15 business days.

End of report.

SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Jordann Nelson
LICENSING EVALUATOR SIGNATURE:

DATE: 06/08/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/08/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 06-CC-20210323152648
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: TUTOR TIME CHILD CARE/LEARNING CENTER
FACILITY NUMBER: 304370276
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/08/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/08/2021
Section Cited
CCR
101226(a)(2)
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Health Related Services The licensee shall immediately notify the child's authorized representative if the child becomes ill or sustains an injury more serious than a minor cut or scratch. This was not met as evidence by...
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The facility director will generate a trainning ensuring that the staff will know when to docment an generate an incident report and aan ouch report to the parents when various incidents occur. The plan of correction is due in 30 days.
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Based on interviews during the complaint investigation. The facility director staff did not generate an incident report or an ouch report communicating a bruise that the child in care sustained. This is a requirement to communicate with parents of inicidents that occur while the child is 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: Patricia Magana
LICENSING EVALUATOR NAME: Jordann Nelson
LICENSING EVALUATOR SIGNATURE:

DATE: 06/08/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/08/2021
LIC9099 (FAS) - (06/04)
Page: 3 of 3