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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304371533
Report Date: 06/10/2024
Date Signed: 06/10/2024 02:36:16 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
04/29/2024 and conducted by Evaluator Cindy Nguyen
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20240429152034
FACILITY NAME:EVERBROOK ACADEMYFACILITY NUMBER:
304371533
ADMINISTRATOR:BROWN, BARBARAFACILITY TYPE:
830
ADDRESS:16498 ROYAL OAKTELEPHONE:
(949) 559-6810
CITY:IRVINESTATE: CAZIP CODE:
92618
CAPACITY:30CENSUS: 7DATE:
06/10/2024
UNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Acting Director, Sandra JohnsonTIME COMPLETED:
03:15 PM
ALLEGATION(S):
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Staff handled day-care child in a rough manner.
Staff yelled at day-care child.
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: 7 napping infant children with 2 staff members. 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 (1) staff handled day-care child in a rough manner and (2) staff yelled at day-care child. During the investigation, LPA Nguyen conducted 2 physical plant inspections, interviewed 3 staff members, and obtained a copy of the children's roster. LPA did not interview children due to age, limited vocabulary and did not qualify for interview. LPA couldn’t interview the complainant due to incorrect contact information provided. Continued on 9099C
Substantiated
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 3
Control Number 06-CC-20240429152034
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: 304371533
VISIT DATE: 06/10/2024
NARRATIVE
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Page 9099C

Complainant alleged during the first week of April Staff #3 (S3) lifted a child by the arms in an aggressive manner and put a child onto a chair. Complainant also stated that the S3 begins screaming at the child.

During the staff interviews, Staff #1 (S1) disclosed that S1 talked to Staff #3 (S3) twice regarding S1’s tone of voice when talking to children. S1 stated S3 does not yell at children but sounds firm & harsh at times. S3 admitted they picked up a child under the armpit to remove the child from a biting situation, and it may have looked a little harsh. S3 stated S3 sometimes raises their voice and says, “get down!”, which may sound harsh to some people.

On 5/20/2024, LPA called seven parents requesting an interview. Two parents were reached. The parents interviewed did not express any concerns related to the allegations and did not provide any information that could corroborate the allegations. The rest of the parents did not respond to the Department’s request for an interview.

Based on the information gathered from LPA's interviews with 3 staff members, it has been determined staff handled day-care child in a rough manner and staff yelled at day-care child. The preponderance of evidence standard has been met; therefore, the above allegations are found to be SUBSTANTIATED. California Code of Regulations, Title 22, 101223(a)(2) Personal Rights are being cited on the attached LIC9099D.

Exit interview was conducted with Acting Director, Sandra Johnson. Notice of Site Visit was posted during the visit. 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. 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 3
Control Number 06-CC-20240429152034
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: 304371533
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/10/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/24/2024
Section Cited
CCR
101223(a)(2)
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101223(a)(2) Personal Rights (a) The licensee shall ensure that each child is accorded the following personal rights: (2) To be accorded safe, healthful, and comfortable accommodations, furnishings, and equipment to meet his/her needs. This requirement was not met evidence by:
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Acting Director stated she will provide personal rights training to staff and provide proof of attendance to LPA by the due date.
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Based on interviews conducted by LPA, it was determined S3 handled day-care child in a rough manner and staff yelled at day-care child, which poses an potential Health, Safety or Personal Rights risk to persons 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: Patricia Magana
LICENSING EVALUATOR NAME: Cindy Nguyen
LICENSING EVALUATOR SIGNATURE:

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

DATE: 06/10/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3