<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304371093
Report Date: 11/18/2021
Date Signed: 11/18/2021 03:59:07 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
11/18/2021 and conducted by Evaluator Ryan Joseph Chan
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20211118132140
FACILITY NAME:FULLERTON CHILDREN'S ACADEMYFACILITY NUMBER:
304371093
ADMINISTRATOR:FLORENCE DIXONFACILITY TYPE:
850
ADDRESS:3516 W. COMMONWEALTH AVENUETELEPHONE:
(714) 680-0567
CITY:FULLERTONSTATE: CAZIP CODE:
92833
CAPACITY:62CENSUS: 40DATE:
11/18/2021
UNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Margarita Calero - Assistant DirectorTIME COMPLETED:
01:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility is in disrepair.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Ryan Chan conducted an unannounced complaint investigation regarding above allegation. LPA met with Assistant Director Margarita Calero who guided LPA on a tour of the facility. LPA observed 5 children in the toddler room with 1 teacher and 40 preschool aged children with 4 teachers. During today’s inspection the facility was operating within its licensed capacity and within compliance of staffing ratios. Facility representative was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

A complaint was received by the Orange County Regional Office on 11/18/21 stating the facility was in disrepair. Assistant director took LPA on a tour of the facility grounds inside and outside.
(Continued on page 2)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Rina Lopez
LICENSING EVALUATOR NAME: Ryan Joseph Chan
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2021
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 5
Control Number 06-CC-20211118132140
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: FULLERTON CHILDREN'S ACADEMY
FACILITY NUMBER: 304371093
VISIT DATE: 11/18/2021
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Page 2

During the walk through of the play yard LPA observed one slide which had 2 missing screws on top of the slide, there was one screw holding the slide on top and there is another slide with a wooden support on the bottom of the slide which needs to be repaired. Both slides are still useable and can hold weight. There is an open access hole on the side of the building by the play area which is approximately 6 inches by 12 inches missing a screen.

Based on LPAs observations, the licensee failed to keep the childcare center in good repair at all times to ensure the safety and well-being of children, employees and visitors. This requirement was not met as evidenced by slides with missing screws or unstable support and an open access hole on the side of the building. Therefore, the preponderance of evidence standard has been met, therefore the above allegation facility is in disrepair is found to be substantiated. California Code of Regulations, Title 22, Section 101238 is being cited on the attached LIC 9099D.

Exit interview was conducted. Notice of Site Visit was posted during the visit. Assistant 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. Assistant 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: Rina Lopez
LICENSING EVALUATOR NAME: Ryan Joseph Chan
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 06-CC-20211118132140
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: FULLERTON CHILDREN'S ACADEMY
FACILITY NUMBER: 304371093
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/18/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/26/2021
Section Cited
CCR
101238(a)
1
2
3
4
5
6
7
101238 Buildings and Grounds
(a) The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors.

This requirement was not met as evidenced by:
1
2
3
4
5
6
7
Assistant director will email LPA pictures of repairs made to play structures and access hole on the side of the building

Ryan.Chan@dss.ca.gov
8
9
10
11
12
13
14
Based on LPAs observations, the licensee failed to keep the childcare center in good repair at all times to ensure the safety and well-being of children, employees and visitors which poses a potential risk to the health and safety of children in care.
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: Rina Lopez
LICENSING EVALUATOR NAME: Ryan Joseph Chan
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2021
LIC9099 (FAS) - (06/04)
Page: 3 of 5