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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304370647
Report Date: 09/01/2023
Date Signed: 09/01/2023 04:17:16 PM

Document Has Been Signed on 09/01/2023 04:17 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
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:SANTA ANA COLLEGE CDC RANCHO SANTIAGO COMMUNITYFACILITY NUMBER:
304370647
ADMINISTRATOR:COWAN,J/CASTELLON,MFACILITY TYPE:
850
ADDRESS:1530 WEST 17TH ST. BLDG VTELEPHONE:
(714) 564-6890
CITY:SANTA ANASTATE: CAZIP CODE:
92706
CAPACITY: 160TOTAL ENROLLED CHILDREN: 160CENSUS: 88DATE:
09/01/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Jerelyn Cowan - DirectorTIME COMPLETED:
04:20 PM
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An unannounced case management inspection was conducted on this date by Licensing Program Analyst (LPA) Carmen Odom in response to a self-reported incident dated 8/25/23. Present during today’s inspection was the Director Jerelyn Cowan. Upon arrival Director took LPA on tour of the facility and census was taken in individual classrooms. The overall census observed was 88 preschool age children and 23 staff members.
A review of adult records 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 8/25/2023 an Unusual Incident Report was filed with the Department to self-report an incident that occurred on 8/21/2023. Director reported on the morning of 8/22/23 Parent #1 (P1) spoke with Staff #6 (S6) regarding an allegation Child #1 (C1) had disclosed to P1. C1 told P1 that on 8/21/23 Staff #1 (S1) had squeezed their cheeks and hit their arm. Staff #5 (S5) told P1 that they would conduct an internal investigation regarding the allegation.

During the investigation, LPA obtained personnel report, children’s roster, interviewed 5 staff, 5 children and reviewed records obtained. S5 stated on 8/22/23 at 1:00pm they went to the district office to review the video footage of 8/21/23 from the hours of 10:25am to 12:45pm, according to the video footage S1 was never observed placing their hands on C1’s face or arm. S5 stated according to the video footage it was observed S1 speaking to the children, C1 looked in a good mood and helped S1 during lunch. C1 sat next to S1 during lunch and C1 did not seem scared or upset around S1. S5 interviewed the staff that were present on 8/21/23, none of the staff disclosed observing S1 touching C1 face or arm. S1 stated on 8/21/23 after large group/small group Staff #2 (S2) opened the sliding doors to the classroom patio, there was a group of 10 children that went outside to play including C1. C1 was playing with the marble maze, S1 noticed C1 had build a weapon with the marble maze pieces and was shooting at Child #2 (C2), S1 told C1 “don’t do that because it’s not nice” in calm tone of voice.
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SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Carmen Odom
LICENSING EVALUATOR SIGNATURE: DATE: 09/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/01/2023
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION 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: SANTA ANA COLLEGE CDC RANCHO SANTIAGO COMMUNITY
FACILITY NUMBER: 304370647
VISIT DATE: 09/01/2023
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S1 stated they never touched C1, and they were a few steps away from C1. LPA also interviewed the 3 staff that were in the classroom on 8/21/23, none of the staff disclosed any concerns. Four out of five children qualified for interviews, none of the children disclosed any inappropriate physical interaction with the children in care. Two of the four children disclosed that the staff will talk to the children when the children are not behaving. S5 stated P1 requested S1 to be removed from C1’s classroom. The last day S1 had any interaction with C1 was on 8/22/23. C1 continues to attend the childcare center.

Statements made by staff and children indicate that S1 did not grab or hit C1 on the face or arm. Reporting requirements were met. Based on LPA observations, interviews conducted, and records/documentation reviewed, there is no evidence to support any violation of Title 22 regulations. No Title 22 deficiencies cited during today's inspection.

Exit interview was conducted with Director Jerelyn Cowan. Notice of Site Visit was posted during the inspection. Facility representatives 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. Facility representatives was provided a copy of their appeal rights (LIC 9058 01/16) and their signature on this form acknowledges receipt of these rights. First level appeals should be sent to the regional manager to the address listed above.
SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Carmen Odom
LICENSING EVALUATOR SIGNATURE:

DATE: 09/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/01/2023
LIC809 (FAS) - (06/04)
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