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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304370730
Report Date: 05/10/2023
Date Signed: 05/10/2023 10:45:06 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, 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
03/10/2023 and conducted by Evaluator Cindy Nguyen
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20230310094745
FACILITY NAME:ACADEMY ON THE HILLSFACILITY NUMBER:
304370730
ADMINISTRATOR:DEL REAL, VERONICAFACILITY TYPE:
850
ADDRESS:10 MAREBLUTELEPHONE:
(949) 360-7022
CITY:ALISO VIEJOSTATE: CAZIP CODE:
92656
CAPACITY:102CENSUS: 96DATE:
05/10/2023
UNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Director, Monica RamirezTIME COMPLETED:
11:30 AM
ALLEGATION(S):
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Day care child sustained unexplained injuries while in care.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Cindy Nguyen conducted an unannounced complaint investigation. This is a continuation of the investigation initiated on 03/16/2023. LPA met with the Director, Monica Ramirez and informed the purpose of the investigation inspection. Census was taken as follow: 96 preschool children with 9 staff members. A review of staff criminal records indicates all facility staff or individuals who require caregiver background checks have received a criminal record clearance or exemption and a child abuse index clearance.

On 3/10/2023 a complaint was filed with the Department alleging that day care child sustained unexplained injuries while in care. During the investigation, LPA Nguyen conducted 2 physical plant inspection on 3/16/2023 and 5/10/2023, interviewed complainant, 4 staff members, 7 parents, obtained and reviewed 1 child record, parent handbook and children's roster.

Continued on Page 2


Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Cindy Nguyen
LICENSING EVALUATOR SIGNATURE:

DATE: 05/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2023
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 4
Control Number 06-CC-20230310094745
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: ACADEMY ON THE HILLS
FACILITY NUMBER: 304370730
VISIT DATE: 05/10/2023
NARRATIVE
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Page 2

Complainant alleged that the day care child sustained unexplained injuries while in care. When notified the school about the incident on 03/03/2023, S2 dismissed it and stated that it is the child fault for being fussy and throwing tantrum.

All four staff interviewed stated that they didn’t witness this injury occur, nor were able to determine its origin. Staff #2 (S2) stated, staff noticed a marked on the child’s neck, when staff and child went back to the classroom to sit at the table. S2 stated, while C1 was throwing themselves on the bathroom floor, S2 was attempting to get C1 up from the floor, the injury could have occurred during the struggle. The facility and S2 are uncertain on how the child received the injury.

LPA called 10 parents, LPA was able to interview 7 parents on 03/21/23. All parents interviewed made no disclosures, parents stated that the facility communicates with parents on what is going on with their child(ren) when needed. Parents did not express any concerns with the care given to the children, or any issue with any staff at the facility.

On 3/16/2023, LPA reviewed C1’s record for incident reports and communication logs. LPA observed there was communication back and forth from the facility about C1 on a daily basis although LPA didn’t observe an incident report nor any communication in the communication log from the facility about this incident. C1 is not qualify for the interview.

On 3/16/2023, LPA attempted to interview all of children present, but was not able to qualify any of the children due to children being nonverbal or limited vocabulary.

Based on LPA’s interviews conducted with complainant, 4 staff members, 7 parents, and records reviewed of child’s file, photo received of 2 linear red mark starches on C1 left neck. Mark #1 appears to be approximately 4 inches, and the second mark is approximately 1 inch, the preponderance of evidence standard has been met; therefore, the above allegation of day care child sustained unexplained injury while in care is found to be SUBSTANTIATED. California Code of Regulations, Title 22 101229(a) Responsibility for Providing Care and Supervision.

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SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Cindy Nguyen
LICENSING EVALUATOR SIGNATURE:

DATE: 05/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 06-CC-20230310094745
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: ACADEMY ON THE HILLS
FACILITY NUMBER: 304370730
VISIT DATE: 05/10/2023
NARRATIVE
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Exit interview was conducted with Director Monica Ramirez. Notice of Site Visit was posted during the visit. 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. Director 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: Patricia Magana
LICENSING EVALUATOR NAME: Cindy Nguyen
LICENSING EVALUATOR SIGNATURE:

DATE: 05/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 06-CC-20230310094745
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: ACADEMY ON THE HILLS
FACILITY NUMBER: 304370730
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/10/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/24/2023
Section Cited
CCR
101229(a)
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101229 Responsibility for Providing Care and Supervision (a) The licensee shall provide care and supervision as necessary to meet the children's needs. This requirement is not met as evidenced by:
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Director stated she will go over the supervision policies with all staff and each staff signed the supervision policy. Director stated she will provide a written statement with supervision POC by 5/24/2023.
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Based on interviews from all staff, it was disclosed that they did not observe when or how the injury occur. They believe it happened when the child throws themselves on the bathroom floor. This is a potential risk to the health and safety of children 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: Cindy Nguyen
LICENSING EVALUATOR SIGNATURE:

DATE: 05/10/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2023
LIC9099 (FAS) - (06/04)
Page: 4 of 4