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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304370986
Report Date: 05/14/2024
Date Signed: 05/14/2024 04:23:38 PM

Document Has Been Signed on 05/14/2024 04:23 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
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:KIDDIE ACADEMY OF HUNTINGTON BEACHFACILITY NUMBER:
304370986
ADMINISTRATOR/
DIRECTOR:		NICOLE CARREONFACILITY TYPE:
830
ADDRESS:19342 BEACH BLVD.TELEPHONE:
(714) 968-0078
CITY:HUNTINGTON BEACHSTATE: CAZIP CODE:
92648
CAPACITY: 44TOTAL ENROLLED CHILDREN: 44CENSUS: 17DATE:
05/14/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:31 PM
MET WITH:Director Nicole CarreonTIME VISIT/
INSPECTION COMPLETED:
05:00 PM
NARRATIVE
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On 05/14/2024, Licensing Program Analyst (LPA) Romy Castanon conducted a Case Management due to information provided to LPA during visit on 02/27/2024. LPA met with and explained the reason for today’s visit. LPA observed 17 infants and 7 staff.

A review of the Facility Personnel Report Summary on 05/14/2024 indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

During LPA’s visit on 02/27/2024, LPA interviewed 11 staff members regarding an incident of a child being bitten on the face. During interviews, LPA verified that the incident happened at 1:15pm and first aid was not applied until 1:30pm. Staff informed LPA that they were unable to leave the classroom and did not notify the front desk for assistance. An ice pack was applied when an extra staff member was available for coverage at 1:30pm. Facility handbook (page 25) states when a child is bitten, they will immediately wash the site with soap and water.

During record review of incident reports, there were five (5) incidents of Child #1 (C1) biting other children. In 2024, there were and additional five (5) incidents of C1 biting other children. Facility handbook (page 25) states if biting behavior continues a parent conference is held and disenrollment may occur if there is no improvement in the biting behavior. LPA was unable to verify if a parent meeting was held to discuss C1’s biting behavior. Director states C1’s parents were verbally notified on the day of all incidents and all incident reports were signed. Director states there have not been any further biting incidents from C1 for the past three (3) month period.

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SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Romelia M Castanon
LICENSING EVALUATOR SIGNATURE: DATE: 05/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/14/2024
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
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: KIDDIE ACADEMY OF HUNTINGTON BEACH
FACILITY NUMBER: 304370986
VISIT DATE: 05/14/2024
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Based on LPA’s interview with staff members and record review, the facility is being cited in accordance with California Code of Regulations, Title 22, Division 12, Section 101223 (a)(3) Personal Rights and 101226 Health-Related Services is cited on the attached LIC9099D.

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. Exit interview conducted and report was reviewed with Director Nicole Carreon.

Upon receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. Licensee shall have LIC9224 (Acknowledgement of Receipt) signed and kept in each child's file.

End of Report

SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Romelia M Castanon
LICENSING EVALUATOR SIGNATURE:

DATE: 05/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2024
LIC809 (FAS) - (06/04)
Page: 2 of 4
Document Has Been Signed on 05/14/2024 04:23 PM - It Cannot Be Edited

Citations on this Visit Report are Under Appeal!


Created By: Romelia M Castanon On 05/14/2024 at 03:27 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: KIDDIE ACADEMY OF HUNTINGTON BEACH
FACILITY NUMBER: 304370986

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/14/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Under Appeal
Type A
05/15/2024
Section Cited
CCR
101223(a)(2)

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101223(a)(2) Personal Rights: (a)The licensee shall ensure that each child is accorded the following personal rights: (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs. This requirement is not met as evidenced by:
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Director stated they would follow the facility biting policy and conduct parent meetings for future biting behavior. Director stated they will document any parent interactions with famililies regarding behavioral issues.
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Based on LPA's interviews and record review, C1 had 10 incidents of biting total and facility did not follow biting policy to prevent injuries to other infants. This poses an immediate health, safety or personal rights to persons 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.
SUPERVISOR'S NAME:Patricia Magana
LICENSING EVALUATOR NAME:Romelia M Castanon
LICENSING EVALUATOR SIGNATURE:
DATE: 05/14/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/14/2024


LIC809 (FAS) - (06/04)
Page: 3 of 4
Document Has Been Signed on 05/14/2024 04:23 PM - It Cannot Be Edited

Citations on this Visit Report are Under Appeal!


Created By: Romelia M Castanon On 05/14/2024 at 03:32 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: KIDDIE ACADEMY OF HUNTINGTON BEACH
FACILITY NUMBER: 304370986

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/14/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Under Appeal
Type B
05/17/2024
Section Cited
CCR
101226(b)

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101226 Health-Related Services (b) The licensee shall make prompt arrangements for obtaining medical treatment for any child if necessary. This requirement was not met as evidenced by:
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Director stated they will add first aid procedures topics to all staff meeting and email LPA signed attendance sheet by POC date.
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Based on intervirew with staff, a child was bitten on the face and staff did not call front desk for assistance and instead waited 15 minutes to apply an ice pack to the child. This poses a potential health, safety or personal rights risks to persons 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.
SUPERVISOR'S NAME:Patricia Magana
LICENSING EVALUATOR NAME:Romelia M Castanon
LICENSING EVALUATOR SIGNATURE:
DATE: 05/14/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/14/2024


LIC809 (FAS) - (06/04)
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