070211160-8-3-2021-02-CC-MMEA-C62NNZ-20210819103733

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 070211160
Report Date: 08/03/2021
Date Signed: 08/03/2021 01:23:40 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/11/2021 and conducted by Evaluator Melissa Domantay

PUBLIC

COMPLAINT CONTROL NUMBER: 02-CC-20210611161202

FACILITY NAME:	FIRST LUTHERAN CHRISTIAN PRESCHOOL		FACILITY NUMBER:	070211160
ADMINISTRATOR:	BARRY, MARIANNA		FACILITY TYPE:	850
ADDRESS:	4006 CONCORD BOULEVARD		TELEPHONE:	(925) 798-5330
CITY:	CONCORD	STATE: CA	ZIP CODE:	94519
CAPACITY:	60	CENSUS: 50	DATE:	08/03/2021
		UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Jeni Smith		TIME COMPLETED:	02:03 PM

ALLEGATION(S):

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Lack of supervision resulting in inappropriate interactions between day-care children.

INVESTIGATION FINDINGS:

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On August 3, 2021 at 10:00 AM Licensing Program Analysts (LPAs) Melissa Domantay and Melissa Guirit conducted an unannounced complaint investigation. LPAs met with director Jeni Smith. Present for this visit were 50 children and 13 staff members. During today's inspection a follow up interview was conducted with school-age teacher's aide and director.

During the course of the investigation, LPAs conducted interviews with staff and parents. Staff interviews indicated that children were involved in inappropriate interactions during facilities operating hours. Parent interviews indicated that children were involved in inappropriate interations. Parents were contacted by the facility staff of the incident.

Based on interviews with staff and parents , the allegation is found to be supported by a preponderance of the evidence, and the complaint is substantiated. The California Code of Regulations Title 22, Division 12, Chapter 1, Article 06, section 101229 (a)(1) is being cited on the attached 9099D. Exit interview was conducted with Director Jeni Smith, appeal rights, and notice of site visit provided to Director. This report must remain on file for 3 years.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Mayla Mendoza	TELEPHONE: (510) 292-9724
LICENSING EVALUATOR NAME: Melissa Domantay	TELEPHONE: 510-725-7021
LICENSING EVALUATOR SIGNATURE:	DATE: 08/03/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/03/2021

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 02-CC-20210611161202

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: FIRST LUTHERAN CHRISTIAN PRESCHOOL	FACILITY NUMBER: 070211160
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/03/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 08/04/2021 Section Cited CCR 101229(a)(1)	1 2 3 4 5 6 7	101229 (a) The licensee shall provide care and supervision as necessary to meet the children's needs. (1) No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation. This requirement was not met as evidence by	1 2 3 4 5 6 7	Director will submit a written plan on how they are going to provide 100% supervision of children during outdoor play. The plan will include how teachers will be placed to ensure that all hidden areas/blind spots will be visulally covered. Director must submit plan to LPA Domantay by 8/4/2021.
	8 9 10 11 12 13 14	based on interviews with staff and parents LPAs obtained evidence that pertained to children involved in inappropriate interactions with each other. Which poses an immediate risk to the health and safety of the childrens's in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Mayla Mendoza	TELEPHONE: (510) 292-9724
LICENSING EVALUATOR NAME: Melissa Domantay	TELEPHONE: 510-725-7021
LICENSING EVALUATOR SIGNATURE:	DATE: 08/03/2021

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/03/2021

LIC9099 (FAS) - (06/04)

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