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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304370879
Report Date: 09/08/2021
Date Signed: 09/08/2021 03:49:11 PM

Unsubstantiated


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
06/11/2021 and conducted by Evaluator Sherene Hawkins
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20210611095433
FACILITY NAME:KIDDIE ACADEMY OF TUSTINFACILITY NUMBER:
304370879
ADMINISTRATOR:ESTRADA, ELAINAFACILITY TYPE:
850
ADDRESS:14501 NEWPORT AVENUETELEPHONE:
(714) 508-0005
CITY:TUSTINSTATE: CAZIP CODE:
92780
CAPACITY:72CENSUS: 54DATE:
09/08/2021
UNANNOUNCEDTIME BEGAN:
01:50 PM
MET WITH:Elaina Estrada TIME COMPLETED:
04:10 PM
ALLEGATION(S):
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Lack of supervision resulting in child getting injured
Facility not reporting unusual incidents to parents

INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Hawkins conducted a follow up investigation on September 8, 2021 at 1:50 PM regarding a complaint which was initiated on June 21, 2021 by LPA Valencia. During today’s visit LPA provided the complaint findings to the director, Elaina Estrada. At 2:10 PM LPA toured the center including all activity/classrooms. Current census observed was 54 preschool children napping and 3 staff supervising in classrooms 3, 4, and 5. A review of staff records on this date indicates that all facility staff or other individuals who required caregiver background checks have received criminal record and child abuse index clearances or exemptions.
On June 11, 2021 the Department received a complaint alleging that staff do not report unusual incidents to parents, and a daycare child was injured during class time as a result of two children arguing over a pencil while one staff was teaching children and the other staff present was on the telephone.
During the investigation, LPA interviewed four staff, eight parents, six children and reviewed facility rosters and incident reports. ***continued on page 2***
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Sherene Hawkins
LICENSING EVALUATOR SIGNATURE:

DATE: 09/08/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/08/2021
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 6
Control Number 06-CC-20210611095433
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: KIDDIE ACADEMY OF TUSTIN
FACILITY NUMBER: 304370879
VISIT DATE: 09/08/2021
NARRATIVE
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***page 2***

In regard to the allegation of lack of supervision resulting in child being injured, all staff interviewed reported that children were being supervised with two staff present in the kinder classroom as they were engaged in activities on the carpet and at the table. During the activity time two children, Child #1 (C1) and Child #2 (C2) were coloring at the table when they began to argue and tussle over a color pencil. In the mix of the pulling and pushing to retrieve the pencil, C1 was scratched on the eye lid. Staff #1 (S1) reported that C1 received first aid care immediately by Staff #3 (S3) in the class. Both C1 and C2 reported to S2 and S3 that it was an accident. C2 reported that C1 was scratched on accident when C1 and C2 were coloring together and tussling over a color pencil. Children interviewed reported two teachers were present in the class engaging with, and supervising the children. All staff and children interviewed reported that staff does not use cell phones in the classroom. C1 is no longer enrolled at the facility and was unable to be contacted for an interview.

In regard to the allegation of facility not reporting unusual incidents to parents, it was reported that Parent #15 (P15) was informed verbally over the telephone regarding an injury to C1 at the facility, however a written report was never received. Staff interviewed reported that P15 was informed regarding the accident to C1 soon after the injury occurred by telephone. The copy of the accident (ouch) report was given to P15 the following day by S3 on 6/11/21, however parent declined to sign. Staff added that accidents to children are reported to the authorized representative/parents either by phone, written report, or verbally depending on the severity of the accident/injury, and or the combination of all three methods. Parents interviewed reported that they are satisfied with the care and supervision provided to their children and concerns are addressed with director. Another parent reported that they were not satisfied with the care provided by the facility, did not choose to elaborate, and will address the concerns later. During the investigation multiple attempts were unsuccessfully made via telephone and U.S. mail to contact additional persons involved in complaint.

***continued on page 3***

SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Sherene Hawkins
LICENSING EVALUATOR SIGNATURE:

DATE: 09/08/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/08/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 6
Control Number 06-CC-20210611095433
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: KIDDIE ACADEMY OF TUSTIN
FACILITY NUMBER: 304370879
VISIT DATE: 09/08/2021
NARRATIVE
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***page 3***

This agency has investigated the complaint alleging that staff are not adequately supervising childcare children resulting in a child being injured, and facility does not report accidents to authorized representative/parents. Based on conflicting statements received during the investigation, we have found that the complaint was unsubstantiated. While the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur.


Exit interview was conducted with director Elaina Estrada. The Notice of Site Visit was posted. Facility representative 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. Appeal Rights were explained. A copy of their appeal rights (LIC 9058) was given and signatures on this form acknowledges receipt of these rights. All appeals must be in writing and received by the licensing office within 15 business days. The first level appeal is to regional manager; address is above on the report.
SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Sherene Hawkins
LICENSING EVALUATOR SIGNATURE:

DATE: 09/08/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/08/2021
LIC9099 (FAS) - (06/04)
Page: 3 of 6
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
06/11/2021 and conducted by Evaluator Sherene Hawkins
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20210611095433

FACILITY NAME:KIDDIE ACADEMY OF TUSTINFACILITY NUMBER:
304370879
ADMINISTRATOR:ESTRADA, ELAINAFACILITY TYPE:
850
ADDRESS:14501 NEWPORT AVENUETELEPHONE:
(714) 508-0005
CITY:TUSTINSTATE: CAZIP CODE:
92780
CAPACITY:72CENSUS: 54DATE:
09/08/2021
UNANNOUNCEDTIME BEGAN:
01:50 PM
MET WITH:Elaina Estrada TIME COMPLETED:
04:10 PM
ALLEGATION(S):
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Child not allowed to go to the restroom
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Hawkins conducted a follow up investigation on September 8, 2021 at 1:50 PM regarding a complaint which was initiated on June 21, 2021 by LPA Valencia. During today’s visit LPA provided the complaint findings to the director, Elaina Estrada. At 2:10 PM LPA toured the center including all activity/classrooms. Current census observed was 54 preschool children napping and 3 staff supervising in classrooms 3, 4, and 5. A review of staff records on this date indicates that all facility staff or other individuals who required caregiver background checks have received criminal record and child abuse index clearances or exemptions.
On June 11, 2021 the Department received a complaint alleging Child #1 (C1) was not allowed to use the restroom after asking the teacher which resulted in C1 urinating on themselves. Staff #4 (S4) reported that she was the teacher supervising during nap time when C1 urinated on themselves. S4 stated C1 asked to use the restroom, she was asked could she wait, and C1 stated yes. S4 stated that the rule is when she is supervising alone only one child can be in the restroom at a time. S4 added that there was one child
***continued on page 2***
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Sherene Hawkins
LICENSING EVALUATOR SIGNATURE:

DATE: 09/08/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/08/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 6
Control Number 06-CC-20210611095433
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: KIDDIE ACADEMY OF TUSTIN
FACILITY NUMBER: 304370879
VISIT DATE: 09/08/2021
NARRATIVE
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***page 2***

currently using the restroom, however there was an available stall that C1 could have used. S4 stated she would have called for another teacher or made the exception if she would have realized child could no longer wait. S4 reported C1 had to wait for approximately 5-10 minutes before C1 could no longer wait and had an accident on themselves.

Additional staff interviewed reported that they weren’t present in the class during the alleged incident, however it was communicated to them that C1 had an accident and urinated on themselves after requesting to use the restroom to S4 who replied that she had already went. Staff #2 (S2) added that C1 never have accidents and always go to the restroom. Children interviewed reported that they are allowed to go to the potty when they ask however an additional child reported that Staff #3 (S3) says yes during nap time for them to go to the potty, but S4 says no don’t go potty. C1 is no longer enrolled at the facility and was unable to be contacted for an interview.

Based on interviews conducted, the facility staff violated the child’s personal rights by not allowing C1 to use the restroom during nap time after she requested to go, and making her wait 5- 10 minutes which resulted in the child urinating on herself. This poses a potential health and safety risk to the children in care. Therefore, the preponderance of evidence standard has been met, therefore, the above allegation of child not allowed to use the restroom is found to be substantiated. California Code of Regulations, Title 22, Division 12 Section 101223(a)(1) Personal Rights is being cited on the attached LIC 9099D.



Exit interview was conducted with director Elaina Estrada. The report and citation were read and reviewed with the director. The Notice of Site Visit was posted. Facility representative 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. Appeal Rights explained. A copy of their appeal rights (LIC 9058) was given and signatures on this form acknowledges receipt of these rights. All appeals must be in writing and received by the licensing office within 15 business days. The first level appeal is to regional manager; address is above on the report
SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Sherene Hawkins
LICENSING EVALUATOR SIGNATURE:

DATE: 09/08/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/08/2021
LIC9099 (FAS) - (06/04)
Page: 5 of 6
Control Number 06-CC-20210611095433
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: KIDDIE ACADEMY OF TUSTIN
FACILITY NUMBER: 304370879
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/08/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/30/2021
Section Cited
CCR
101223(a)(1)
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Personal Rights 101223(a)(1)The licensee shall ensure that each child is accorded the following personal rights:To be accorded dignity in his/her personal relationships with staff and other persons.
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Director Elaina Estrada will conduct a training for the staff in relation to Personal Rights and update bathroom policy. A sign in sheet will be provided to the Department related to the training discussion and the attendees. Director will email LPA at: Sherene.Hawkins@dss.ca.gov
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This requirement was not met as evidence by C1 being denied by S4 the opportunity to use the restroom, resulting in child urinating on self. This poses a potential health risk to the 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: Judy Hanson
LICENSING EVALUATOR NAME: Sherene Hawkins
LICENSING EVALUATOR SIGNATURE:

DATE: 09/08/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/08/2021
LIC9099 (FAS) - (06/04)
Page: 6 of 6