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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304371532
Report Date: 06/10/2024
Date Signed: 06/10/2024 01:56:16 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
04/29/2024 and conducted by Evaluator Cindy Nguyen
COMPLAINT CONTROL NUMBER: 06-CC-20240429153448
FACILITY NAME:EVERBROOK ACADEMYFACILITY NUMBER:
304371532
ADMINISTRATOR:BROWN, BARBARAFACILITY TYPE:
850
ADDRESS:16498 ROYAL OAKTELEPHONE:
(949) 559-6810
CITY:IRVINESTATE: CAZIP CODE:
92618
CAPACITY:195CENSUS: 66DATE:
06/10/2024
UNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Acting Director, Sandra JohnsonTIME COMPLETED:
02:00 PM
ALLEGATION(S):
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Staff left day-care children unattended on the playground.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Cindy Nguyen conducted an unannounced complaint investigation. This is a continuation of the investigation initiated on 05/02/2024. Upon arrival LPA met with, Sandra Johnson, Acting Director who accompanied LPA on a tour of the facility. Census was taken as follow: 66 napping preschool children with 7 staff members. During the inspection it was determined the facility is operating within its licensed capacity and within compliance of staff to child ratios. A review of the Facility Personnel Report Summary on this date indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

On 04/29/2024 a complaint was filed with the Department alleging that a staff left day-care children unattended on the playground. During the investigation, LPA Nguyen conducted 2 physical plant inspections, interviewed 3 staff members, 3 children and obtained a copy of the children's roster. LPA couldn’t interview the complainant due to the wrong contact information were provided. Continued on 9099C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Cindy Nguyen
LICENSING EVALUATOR SIGNATURE:

DATE: 06/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2024
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-20240429153448
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: EVERBROOK ACADEMY
FACILITY NUMBER: 304371532
VISIT DATE: 06/10/2024
NARRATIVE
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Page 9099C

Complainant alleged that on April 1, 2024, complainant observed a staff member bring a child inside the classroom to look for the child shoes and left all the other children outside on the playground unsupervised. Complainant stated that there were two other teachers that observed the incident.

During the staff interview, Staff #2 (S2) stated they were supervising children in the playground, and noticed another class was lining up to go outside, S2 was unable to see a staff member with the children and shouted, “who is there?” Staff #4 (S4), (who no longer works for the facility), stated they were inside the classroom door looking for a child’s shoe. S2 continued to watch the children that were lining up and talked about supervision to S4 afterward. Staff #3 (S3) stated they observes S4 at the door where they had visual supervision of all the children lining up as well as the child in the classroom getting their shoes. LPA attempted to contact S4 twice but was unable to interview S4.

LPA interviewed three children. The children did not disclose any pertinent information regarding the allegation of this complaint.

On 5/20/2024, LPA called six parents requesting an interview. No parents were reached for the interview.

Based on LPA observations, and interviews which were conducted, the preponderance of evidence that staff left day-care children unattended on the playground was not met, therefore the above allegation is found to be UNSUBSTANTIATED. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is UNSUBSTANTIATED.

Exit interview was conducted with Acting Director, Sandra Johnson. Notice of Site Visit was posted during the visit. Acting 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. Acting 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: Patricia Magana
LICENSING EVALUATOR NAME: Cindy Nguyen
LICENSING EVALUATOR SIGNATURE:

DATE: 06/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2