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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304371093
Report Date: 02/04/2022
Date Signed: 02/04/2022 12:24:47 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
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: 28DATE:
02/04/2022
UNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Margarita Calero - DirectorTIME COMPLETED:
11:00 AM
ALLEGATION(S):
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Facility does not provide a safe environment for children in care.
INVESTIGATION FINDINGS:
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On 02/04/22 Licensing Program Analyst (LPA) Ryan Chan conducted an unannounced complaint investigation visit regarding the allegation stated above. LPA Chan met with facility director Margarita Calero who took LPA on a tour of the facility. There was a total of 28 children with 5 staff.

A review of the Facility Personnel Report Summary conducted on 02/04/22 indicates all facility staff or other individuals who required caregiver background checks have received criminal record and child abuse index clearances or exemptions.

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.
(Continued on page 2)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Ryan Joseph Chan
LICENSING EVALUATOR SIGNATURE:

DATE: 02/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2022
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 9
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: 02/04/2022
NARRATIVE
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Page 2
On 11/18/21 the Orange County Child Care Office received a complaint alleging facility does not provide a safe environment for children in care. When the complaint was called in, the reporting party (RP) stated staff could work without a physical, proof of immunizations, and proof of TB test. LPA attempted to contact RP but was unsuccessful.

As stated in Title 22 Section 101216(g) all personnel, including the licensee, administrator and volunteers shall be in good health and shall be physically and mentally capable of performing assigned tasks. Good physical health shall be verified by a health screening, including a test for tuberculosis, performed by or under the supervision of a physician not more than one year prior to or seven days after employment or licensure. During the investigation LPA obtained copies of Health Screening Report form LIC 503 for 9 staff. A review of documents revealed 1 of 9 staff (S3) had their TB test performed more than one year prior to employment; 2 of 9 staff (S1 and S4) had their TB test performed more than seven days after employment; and 1 of 9 staff (S2) did not have proof of TB test and physical in their file. Immunization records were reviewed for 9 staff and were in compliance.

Based on records reviewed, the licensee failed to ensure staff are in good physical health verified by a health screening, including a test for tuberculosis, performed by or under the supervision of a physician not more than one year prior to or seven days after employment or licensure. This requirement was not met as evidenced by 3 of 9 staff TB tests were outside the time frame required by the regulation and 1 of 9 staff did not have proof of TB test and physical on file. Therefore, the preponderance of evidence standard has been met, therefore the above allegation alleging facility does not provide a safe environment for children in care is found to be substantiated. California Code of Regulations, Title 22, Division 12, Chapter 1, Section 101216 (g) (1), is being cited on the attached LIC 9099D.

101216 Personnel Requirements
(g) All personnel, including the licensee, administrator and volunteers, shall be in good health and shall be physically and mentally capable of performing assigned tasks.
(1) Except as specified in (3) below, good physical health shall be verified by a health screening, including a test for tuberculosis, performed by or under the supervision of a physician not more than one year prior to or seven days after employment or licensure. (Continued on page 2)
SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Ryan Joseph Chan
LICENSING EVALUATOR SIGNATURE:

DATE: 02/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 9
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: 02/04/2022
NARRATIVE
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Page 3

Exit interview conducted and report was reviewed with director Margarita Calero. Appeal Rights 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. The Notice of Site Visit must be posted on or adjacent to the door.
SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Ryan Joseph Chan
LICENSING EVALUATOR SIGNATURE:

DATE: 02/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 9
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
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: 28DATE:
02/04/2022
UNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Margarita Calero - DirectorTIME COMPLETED:
11:00 AM
ALLEGATION(S):
1
2
3
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5
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9
Day care children are not adequately supervised.
INVESTIGATION FINDINGS:
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13
On 02/04/22 Licensing Program Analyst (LPA) Ryan Chan conducted an unannounced complaint investigation visit regarding the allegation stated above. LPA Chan met with facility director Margarita Calero who took LPA on a tour of the facility. There was a total of 28 children with 5 staff.

A review of the Facility Personnel Report Summary conducted on 02/04/22 indicates all facility staff or other individuals who required caregiver background checks have received criminal record and child abuse index clearances or exemptions.

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.
(Continued on page 2)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Ryan Joseph Chan
LICENSING EVALUATOR SIGNATURE:

DATE: 02/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2022
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 9
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: 02/04/2022
NARRATIVE
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Page 2

On 11/18/21 the Orange County Child Care Office received a complaint alleging day care children are not adequately supervised. When the complaint was called in, the reporting party (RP) stated the kids are allowed to walk into the building to use the restroom without supervision when the class is outside and no staff is inside. LPA attempted to contact RP but was unsuccessful.

During the investigation LPA conducted interviews on 11/18/21, 11/29/21, and 02/02/22 with 9 staff, 7 parents, and 7 children. Interviews with children reveal 3 of 7 children stated if they are outside and have to use the bathroom, they go inside by themselves but are met by another teacher inside where the bathroom is while the other 4 of 7 children stated they are escorted inside by a teacher. Teachers state they have children use the potty before going outside. Interviews with teachers reveal either they call for assistance, take the whole class inside for potty, or for the smaller children they are in diapers. 1 of 9 staff stated she sends the child in the classroom but uses a walkie talkie to alert staff inside that a child is on their way in to use the bathroom and a staff meets the child, the same procedure is used when the child is done with using the bathroom and is returning back outside, the staff inside uses a walkie talkie to alert staff outside that a child is coming out, staff state visual supervision is maintained at all times during this sequence. 1 staff member states she sends children in to go to the bathroom by themselves, staff member states there are teachers inside in the morning but was unsure if there were teachers inside in the afternoon. LPA interviewed parents, 6 of 7 parents did not disclose any concerns. 1 of 7 parents brought up a concern with bathroom breaks, but acknowledges teacher was supervising.

Based on observations and interviews conducted with 9 staff, 7 parents, and 7 children, this complaint is unsubstantiated. There is not enough information to corroborate if children are or are not supervised when children are outside and they go inside to use the bathroom. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.

(Continued on page 3)
SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Ryan Joseph Chan
LICENSING EVALUATOR SIGNATURE:

DATE: 02/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2022
LIC9099 (FAS) - (06/04)
Page: 5 of 9
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: 02/04/2022
NARRATIVE
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Page 3

Exit interview conducted and report was reviewed with director Margarita Calero. Appeal Rights 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. The Notice of Site Visit must be posted on or adjacent to the door.
SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Ryan Joseph Chan
LICENSING EVALUATOR SIGNATURE:

DATE: 02/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2022
LIC9099 (FAS) - (06/04)
Page: 6 of 9
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: 02/04/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/18/2022
Section Cited
CCR
101216(g)
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101216 Personnel Requirements
(g) All personnel, including the licensee, administrator and volunteers...(1) good physical...verified by a health screening, including a test for tuberculosis...not more than one year prior to or seven days after employment or licensure.
This requirement was not met as evidenced by:
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Director will email written statement to LPA that she will ensure physical and TB test are within 1 year of hire up to 7 days after initial prescence is completed for new employees. Director will also email LIC 503 for S2.

ryan.chan@dss.ca.gov
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Based on records reviewed 3 of 9 (S1, S3, and S4) staff TB tests were outside the time frame required by the regulation and 1 of 9 (S2) staff did not have proof of TB test and physical on file which poses 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: Judy Hanson
LICENSING EVALUATOR NAME: Ryan Joseph Chan
LICENSING EVALUATOR SIGNATURE:

DATE: 02/04/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2022
LIC9099 (FAS) - (06/04)
Page: 9 of 9