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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 376700353
Report Date: 11/29/2023
Date Signed: 11/29/2023 11:24:13 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/31/2023 and conducted by Evaluator Amber Shaw
PUBLIC
COMPLAINT CONTROL NUMBER: 10-CC-20231031144413
FACILITY NAME:KIDDIE ACADEMY CHILDCARE LEARNING CENTERFACILITY NUMBER:
376700353
ADMINISTRATOR:PLANT, LISAFACILITY TYPE:
850
ADDRESS:3766 MISSION AVENUE #110TELEPHONE:
(760) 439-5552
CITY:OCEANSIDESTATE: CAZIP CODE:
92058
CAPACITY:126CENSUS: 65DATE:
11/29/2023
UNANNOUNCEDTIME BEGAN:
10:50 AM
MET WITH:Evelyn AvilaTIME COMPLETED:
11:33 AM
ALLEGATION(S):
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Staff provided food items listed as an allergy for day care child
Staff did not provide day care child’s medication as prescribed
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA), Amber Shaw and Licensing Program Manager (LPM) Carlos Martinez, made a subsequent unannounced complaint investigation visit to deliver the findings for the above referenced allegations. LPA met with Evelyn Avila, (Director), who was informed of the decision rendered.

It is alleged that staff provided C1 with food items listed as an allergy on 10/31/23. During course of investigation, LPA reviewed C1’s records and noted that the child had been enrolled since December 2022. The Health History, as signed by the child's parent, indicated that the child had "no known allergies", and no allergies were identified in the file. LPA observed a “Diet Restriction Letter,” signed and dated 12/14/2022, which indicated for C1 not to eat regular milk as a “Personal Preference, ” and not necessarily
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Amber Shaw
LICENSING EVALUATOR SIGNATURE:

DATE: 11/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/29/2023
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 10-CC-20231031144413
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: KIDDIE ACADEMY CHILDCARE LEARNING CENTER
FACILITY NUMBER: 376700353
VISIT DATE: 11/29/2023
NARRATIVE
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    as an allergy. In addition, the Personal Childhood History sheet located in C1’s file indicated “no food allergies”. Based on the information gathered and interviews conducted, LPA determined that the facility was unaware of the child’s allergies until the parent brought it up to their attention, therefore, the allegation that Staff provided food items listed as an allergy for day care child is Unsubstantiated.

During investigation, LPA Shaw conducted an inspection of the facility’s observed that the facility had C1’s medication information on file, and confirmed that the medication was properly stored in a secure area at the facility. According to interviews conducted, the child had been enrolled since 2022 and the facility was aware that the child had asthma but could not recall any incidents that warranted staff to use inhaler on C1. In addition, the teacher of C1 was unaware that C1 was in need of the inhaler because the child did not appear to be in distress and there were no changes in the child’s behavior throughout the day. Based on the investigation findings, LPA Shaw determined that the allegation is Unsubstantiated.

From the information received by interviews with staff, and facility documents the above allegations cannot be verified. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the allegations did or did not occur, therefore, the allegations are UNSUBSTANTIATED.



An exit interview was conducted, a Notice of Site Visit posted, and a copy of this report was provided to the facility on this date and time.
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Amber Shaw
LICENSING EVALUATOR SIGNATURE:

DATE: 11/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/29/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2