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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304370879
Report Date: 07/07/2022
Date Signed: 07/07/2022 01:08:06 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
04/01/2022 and conducted by Evaluator Stella Gutierrez
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20220401123718
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: 60DATE:
07/07/2022
UNANNOUNCEDTIME BEGAN:
11:10 AM
MET WITH:Elaina Alcaraz ,director TIME COMPLETED:
02:00 PM
ALLEGATION(S):
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Reporting Requirements - Staff did not properly report an incident involving a daycare child
INVESTIGATION FINDINGS:
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On 07/07/2022 Licensing Program Analysts (LPA) Stella Gutierrez made an unannounced inspection to the Kiddie Academy of Tustin at 11:10 AM for the purpose of concluding the investigation on the above allegation and to deliver the findings. LPA, Gutierrez met with Elaina Alcaraz, director who was explained the reason for today’s visit. LPA observed 60 preschool staff and 09 preschool children present at the facility
A review of the Facility Personnel Report Summary conducted on 07/07/2022 indicates all facility staff or other individuals who required caregiver background checks have received criminal record and child abuse index clearances or exemptions.

On 04/01/2022 The Department received a complaint for the above allegation that Staff did not properly report an incident involving a daycare child. On 04/05/2022 and 06/23/2022 LPA, Gutierrez conducted an unannounced visit to the facility to investigation the allegation.

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Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Stella Gutierrez
LICENSING EVALUATOR SIGNATURE:

DATE: 07/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2022
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 8
Control Number 06-CC-20220401123718
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: 07/07/2022
NARRATIVE
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During the investigation the facility director disclosed to LPA that on 04/01/2022 the local police department police officer visited the facility to investigate a reported incident. The director admitted to not reporting to Community Care Licensing, the unusual visit from local police department. The “preponderance of the evidence” standard has been met. The allegation of reporting requirements is deemed substantiated.

Type B deficiency will be cited today in accordance to California Code of Regulations, Title 22, Division 1 & Chapter 1, Section Reporting Requirements 101212(d)(1)(C) is being cited on the attached LIC 9099D.

Notice of Site Visit
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.


Exit interview conducted and report was reviewed with Elaina Alcaraz. Appeal Rights and deficiencies were explained, Director was provided a copy of her Appeal Rights and signature on this form acknowledges receipt of these rights. Director was informed all appeals must be in writing and received by the Regional Office within 15 business days. A notice of site visit was given and must remain posted for 30 days. Failure to post will result in civil penalties of $100.00.



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SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Stella Gutierrez
LICENSING EVALUATOR SIGNATURE:

DATE: 07/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 8
Control Number 06-CC-20220401123718
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: 07/07/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/07/2022
Section Cited
CCR
101212(d)(1)(C)
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101212 Reporting Requirements
(d) Upon the occurrence, during the operation of the child care center of any of the events specified in (d)(1) below, a report shall be made to the Department...1) Events reported shall include...(C) Any unusual incident ...
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Director stated that she understands reporting requirements and has self reported incidents in the past. Director reported the addressed incident that took place at the facility on 06/23/2022 to the department of CCLD. Type B deficiency will be cleared during today's visit.
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This requirement was not met as evidence by, records review by CCLD that there was not report for the incident that occurred on 04/1/2022 and the director revealed in a statement that the incident was not reported. This violation can cause a potential harm 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: Patricia Magana
LICENSING EVALUATOR NAME: Stella Gutierrez
LICENSING EVALUATOR SIGNATURE:

DATE: 07/07/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 8
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
04/01/2022 and conducted by Evaluator Stella Gutierrez
COMPLAINT CONTROL NUMBER: 06-CC-20220401123718

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: 60DATE:
07/07/2022
UNANNOUNCEDTIME BEGAN:
11:10 AM
MET WITH:Elaina Alcaraz ,director TIME COMPLETED:
02:00 PM
ALLEGATION(S):
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Lack of supervision - Staff did not properly supervise the daycare children while in care.
Personal Rights- Staff behavior poses as a risk to a daycare child.
Personal Rights- Staff hit a daycare child while in care.
INVESTIGATION FINDINGS:
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On 07/07/2022 Licensing Program Analysts (LPA) Stella Gutierrez made an unannounced inspection to the Kiddie Academy of Tustin for the purpose of concluding the investigation on the above allegations and to deliver the findings. LPA, Gutierrez met with Elaina Alcaraz, director who was explained the reason for today’s visit. LPA observed 60 preschool staff and 09 preschool children present at the facility
A review of the Facility Personnel Report Summary conducted on 07/07/2022 indicates all facility staff or other individuals who required caregiver background checks have received criminal record and child abuse index clearances or exemptions.

Allegation Lack of Supervision resulting in an injury of child #1 hitting their head at school many times in one day and other children bullying C#1 by hitting C#1. Interview conducted with reporting party via phone call on 04/04/2022 and a follow up in person interview on 06/22/2022 regarding the allegation.

Page 1 of 3
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Stella Gutierrez
LICENSING EVALUATOR SIGNATURE:

DATE: 07/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2022
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 8
Control Number 06-CC-20220401123718
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: 07/07/2022
NARRATIVE
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Reporting party stated on 06/22/2022 that she did not have any pictures of injuries to the head or any other parts of C1 body, or names of children who hurt C1. RP did not seek medical attention for her child C1 the day of the incident, the incident was reported to the Tustin Police Department.
Interview conducted with C1 on 04/04/2022 via phone call with reporting party present and in person on 06/22/2022. Regarding the allegation, LPA was not able to qualify C1, due to C1s attention span and unable to provide full details. C1 stated, “My friend’s do pow pow on me” but did not disclose any names of friends that do pow pow on child.
LPA interviewed Staff #1-6 on 04/05/2022 and 06/23/2022, staff made no disclosures. The staff were unaware that C1 was hit or bullied by other children. LPA reviewed C1 file for incident reports, none noted that C1 was hit or bullied by other children.
On 04/05/2022 LPA, Gutierrez conducted an inspection and interviewed Children #2-10, no disclosures were made by children interviewed. LPA interviewed Parents #2-10, no disclosures made regarding C1 being hit by other children. LPA interviewed police officer on 06/17/2022 and obtained a the police report, there was no evidence of injuries on C1.

Based on the interviews and police report the allegation of Lack of supervision Staff did not properly supervise the daycare children while in care is deemed unsubstantiated. The allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred.

Allegation of Personal Rights-Staffs behavior poses a risk to the children in care. It was stated by reporting party that teacher is mean to C1 and throws food out while C1 is still eating.

Interview conducted with C1 ON 04/04/2022 and 06/22/2022 and there was mentioned from C1 of the above alleged allegations. Facility has cameras where parents or authorized representatives can tap in from an app utilized by facility. LPA, Gutierrez conducted interviews with Parents #2-10 and children #2-15 on 04/05/2022 and 06/23/2022. Based on observation and interviews conducted the allegation of Personal rights- staffs behavior poses a risk to the children in care is deemed unsubstantiated.

Based on the interviews conducted during the investigation process and statements obtained during the investigation process, the allegations are deemed unsubstantiated. Although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. Page 2 of 3

SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Stella Gutierrez
LICENSING EVALUATOR SIGNATURE:

DATE: 07/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2022
LIC9099 (FAS) - (06/04)
Page: 5 of 8
Control Number 06-CC-20220401123718
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: 07/07/2022
NARRATIVE
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The Allegation of Personal Rights- Staff hit daycare child while in care.

On 04/04/2022 LPA, Gutierrez interviewed the reporting party and C1 via phone call. RP stated the C1 stated that staff hit C1 on the stomach calling it pow pow, RP stated C1 did not provide any further details.

On 04/04/2022 LPA was not able to qualify child as C1 was distracted during the phone interview. C1 did state that friends pow pow and hit C1 a lot. During the interview when questioned, C1 did not state that a staff member at the facility pow pow or hit. During a follow up interview conducted in person on 06/22/20222 C1 stated staff hit C1 other children in care. C1s statements were inconsistent during interviews.

On 04/05/2022 and on 06/23/2022 LPA, Gutierrez interviewed Children #2-9 during the visit at the facility. Interviews with Child #5, Child #6, Child #7 and Child #9, statements were inconsistent.

On 06/23/2022 LPA interviewed Staff #1---, all stated that they have not witness any staff hit any of the children in care. All staff stated that they have been trained to take the child to the side to discuss it. Director stated that staff are trained on how to discipline children, it includes redirection and/or remove the child from the situation. In addition, the Director stated that all parents have access to cameras and can log on to Amcrest view pro. LPA reviewed staff records on 07/07/2022 for personal rights and disciplinary actions. There were no relevance disciplinary actions that coincide the allegations in question.

Based on interviews conducted with children and staff and file reviews, at this time the allegation is concluded as unsubstantiated. The allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred.


Exit interview conducted and report was reviewed with the director, Elaina Alcaraz. Appeal Rights 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.

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.
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SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Stella Gutierrez
LICENSING EVALUATOR SIGNATURE:

DATE: 07/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2022
LIC9099 (FAS) - (06/04)
Page: 6 of 8