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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371423
Report Date: 04/25/2022
Date Signed: 04/25/2022 03:55:27 PM

Document Has Been Signed on 04/25/2022 03:55 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
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:KIDDIE ACADEMY OF YORBA LINDAFACILITY NUMBER:
304371423
ADMINISTRATOR:CORTEZ,GLORIETTEFACILITY TYPE:
850
ADDRESS:18633 YORBA LINDA BLVD.TELEPHONE:
(714) 660-6111
CITY:YORBA LINDASTATE: CAZIP CODE:
92886
CAPACITY: 120TOTAL ENROLLED CHILDREN: 124CENSUS: 54DATE:
04/25/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Gloriette Cortez, DirectorTIME COMPLETED:
03:00 PM
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Licensing Program Analyst, (LPA) P Rivas conducted an unannounced case management visit to investigate incident reports dated 03/30/22 and 04/11/22 provided by Director, Cortez. The Covid-19 Emergency Response questionnaires were asked. Census; 54 children and 8 staff members. A review of facility Personnel Report Summary on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

LPA had commenced investigation of incidents on 04/19/22.
In reference to the incident of 03/30/22; On previous report LPA referenced incident as incident of 04/01/22 however, it was the incident reported for 03/30/22. Alleged incident involved Child 6(C6) and C7, alleged that C7 drew a graphic inappropriate picture and gave it to C6. During today's visit LPA continued to interview children and staff. Parents were also interviewed from 12:45 to 2:00pm. Interviews with 9 out of 10 children did not divulge any inappropriate or graphic drawings being drawn or shown or seen by children. 1 out of the 10 indicated to having received an inappropriate drawing. Per interview with three staff, they did not observe any inappropriate pictures being drawn or observed. Per 3 teachers interviewed, after drawings are completed children place items in their cubby space(storage); teachers at the end of the day give items from a child's cubby to parents at the end of day and all 3 reported that no inappropriate or graphic pictures were viewed in cubbys. One of three teachers indicated that the two children involved in this incident had given teacher their pictures to post on the wall. LPA viewed pictures posted to be of C6 of a girl with a mask; picture from C7 was picture of a house, with a person; Interview with parents indicated they had not observed, inappropriate, graphic, drawing . Based on interviews, review of records, physical plant tour, LPA did not observe any violation of Title 22 Regulations.


Cont. Page 2
SUPERVISORS NAME: Rina Lopez
LICENSING EVALUATOR NAME: Pat Rivas
LICENSING EVALUATOR SIGNATURE: DATE: 04/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/25/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION 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 YORBA LINDA
FACILITY NUMBER: 304371423
VISIT DATE: 04/25/2022
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Investigation of second incident reported on 04/12/22 allegedly occurred 04/11/22 and it t involved involved C6, C8, C9 . It was alleged that the three children were playing and that teacher overheard children talk about tickling pee pee. Staff states she immediately stopped conversation and C8 allegedly said C6 had told them to say that. LPA interviewed C6 and C8 neither child divulged any of the alleged statements or play. C9 is no longer attending. LPA interviewed one staff who indicated hearing children talk about tickling pee pees. Based on interviews, review of records, physical plant tour, LPA did not observe any violation of Title 22 Regulations.

Exit interview conducted and report was reviewed with Director Cortez. 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: Rina Lopez
LICENSING EVALUATOR NAME: Pat Rivas
LICENSING EVALUATOR SIGNATURE:

DATE: 04/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/25/2022
LIC809 (FAS) - (06/04)
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