191202176-12-14-2021-12-CC-MRAN-C9PSZP-20211214131927

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 191202176
Report Date: 12/06/2021
Date Signed: 12/14/2021 12:17:14 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/15/2021 and conducted by Evaluator Liana Stepanyan

PUBLIC

COMPLAINT CONTROL NUMBER: 12-CC-20211015112232

FACILITY NAME:	CHRIST LUTHERAN CHURCH		FACILITY NUMBER:	191202176
ADMINISTRATOR:	MONICA SANTIAGO-VENEGAS		FACILITY TYPE:	850
ADDRESS:	25816 NORTH TOURNAMENT ROAD		TELEPHONE:	(661) 259-0302
CITY:	VALENCIA	STATE: CA	ZIP CODE:	91355
CAPACITY:	92	CENSUS: 50	DATE:	12/06/2021
		UNANNOUNCED	TIME BEGAN:	11:04 AM
MET WITH:	Monica Santiago		TIME COMPLETED:	12:05 PM

ALLEGATION(S):

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Personal Rights
Personal Rights

INVESTIGATION FINDINGS:

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On 12/06/21, Licensing Program Analyst (LPA) Liana Stepanyan conducted a subsequent complaint investigation to deliver the findings of the above allegation. LPA met with the director Monica Santiago who guided the LPA on a tour of the facility. Upon arrival LPA observed 50 children in care with 7 staff.

The investigation of the above allegation consisted of children and staff interviews including LPAs observations. On 10/19/21, LPAs observed all children playing outdoor without mask, however, when they entered the facility staff would assist child to put on a facial covering. LPA also observed all staff wearing facial covering. During interviews conducted with child #1, child #2, and child #3 it was disclosed they do wear facial coverings while in care and staff wear facial coverings.

During today’s inspection, LPA observed children and staff wearing facial coverings.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Liana Stepanyan	TELEPHONE: 661-202-3380
LICENSING EVALUATOR SIGNATURE:	DATE: 12/06/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2021

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 12-CC-20211015112232

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: CHRIST LUTHERAN CHURCH	FACILITY NUMBER: 191202176
	VISIT DATE: 12/06/2021

NARRATIVE

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Based on observations/interviews/record review the allegation is rendered unsubstantiated. There is not a preponderance of evidence to prove the above allegation. A finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the allegations occurred.

No deficiencies were cited during this inspection.

An exit interview was conducted, a copy of this report, and notice of site visit was provided to the director Monica Santiago along with appeal rights.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Liana Stepanyan	TELEPHONE: 661-202-3380
LICENSING EVALUATOR SIGNATURE:	DATE: 12/06/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2021

LIC9099 (FAS) - (06/04)

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