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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304371442
Report Date: 12/14/2022
Date Signed: 12/14/2022 12:16:33 PM

Unsubstantiated


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
10/17/2022 and conducted by Evaluator Stacy Torrence
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20221017120218
FACILITY NAME:ACACIA MONTESSORI SCHOOLFACILITY NUMBER:
304371442
ADMINISTRATOR:CHUNG, SUNFACILITY TYPE:
830
ADDRESS:1701 EAST CHAPMAN AVENUETELEPHONE:
(336) 870-2176
CITY:FULLERTONSTATE: CAZIP CODE:
92831
CAPACITY:13CENSUS: 8DATE:
12/14/2022
UNANNOUNCEDTIME BEGAN:
11:53 AM
MET WITH:Sun Chang, LicenseeTIME COMPLETED:
12:30 PM
ALLEGATION(S):
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Child left in soiled diaper for extended of time.
Facility operating out of ratio.
INVESTIGATION FINDINGS:
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On 12/14/2022, Licensing Program Analyst (LPA) Stacy Torrence conducted an in-person inspection to deliver the findings regarding the above complaint allegations. LPA Torrence met with Licensee Sun Chang. There was a total of eight infants with five staff supervising. A review of staff criminal clearance records on this date indicated that all facility staff or other individuals who required caregiver background checks have received criminal record and child abuse index clearances or exemptions.
On 10/17/2022, Licensing office received a complaint alleging the following: child left in soiled diaper for extended of time and facility operating out of ratio.

Reporting Party (RP) reported there have been several times when child was picked up, child was left in soiled and poopy diapers. RP also reported infant classroom is often out of ratio with 10 infants and one staff.

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Stacy Torrence
LICENSING EVALUATOR SIGNATURE:

DATE: 12/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2022
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 2
Control Number 06-CC-20221017120218
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: ACACIA MONTESSORI SCHOOL
FACILITY NUMBER: 304371442
VISIT DATE: 12/14/2022
NARRATIVE
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Allegation: Child left in soiled diaper for extended of time.
Licensee stated staff are instructed to make sure diapers and clothes are clean before parents pick up child. Staff 1(S1) stated diapers are changed every 2 hours or as needed. Staff 2 (S2) stated S2 change diapers after nap and at least 15 minutes before they leave for home. Staff 3 (S3) stated diapers are checked in the morning, before nap, after nap, afternoon, then before handing child to parent at pick up. S3 stated diapers are checked every 2 hours; or whenever notice child had a bowl movement or is wet. Staff 4 (S4) stated every child gets change before they go home. All four interviewed staff disclosed the daycare use an application called Bright Wheel to log all diaper changes throughout the day.

During the course of the investigation, LPA Torrence obtained a copy of the diaper log and determined diapers were changed according to staff disclosure.

Allegation: facility operating out of ratio
The four interviewed staff denied witnessing the infant classroom being out of ratio.

During the course of the investigation, LPA reviewed random days of staffs’ timesheets and parent’s sign in/out sheet, it was discovered the facility was in ratio on those days reviewed.

LPA Torrence contacted four parents. Interviewed parents had no issues or concerns.

Based on the information gathered from LPAs' interviews and reviewing records, there is insufficient evidence to corroborate the allegations of child left in soiled diaper for extended of time and facility operating out of ratio. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur; therefore, the allegations are unsubstantiated.

Exit interview was conducted. The Notice of Site Visit was posted. Appeal Rights was explained. A copy of appeal rights (LIC 9058 1/16) will be provided through email and their signatures on this form acknowledges receipt of these rights. First level appeal is to Regional Manager, address is above on the report.
SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Stacy Torrence
LICENSING EVALUATOR SIGNATURE:

DATE: 12/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2