197418346-12-28-2021-12-CC-MRAN-CACM3C-20220104081448

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197418346
Report Date: 12/28/2021
Date Signed: 12/28/2021 11:54:42 AM

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-20211015111156

FACILITY NAME:	BETHLEHEM LUTHERAN SCHOOL		FACILITY NUMBER:	197418346
ADMINISTRATOR:	FERRARA, TONI		FACILITY TYPE:	850
ADDRESS:	27265 LUTHER DRIVE		TELEPHONE:	(661) 251-6027
CITY:	CANYON COUNTRY	STATE: CA	ZIP CODE:	91351
CAPACITY:	98	CENSUS: 0	DATE:	12/28/2021
		UNANNOUNCED	TIME BEGAN:	09:55 AM
MET WITH:	Toni Ferrara, Licensee		TIME COMPLETED:	12:11 PM

ALLEGATION(S):

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Personal Rights-Facility staff do not wear a facial covering

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Liana Stepanyan and Mariela Ramon Licensing Program Manager (LPM) conducted a subsequent complaint investigation inspection for the purpose to deliver the findings of the above allegation. LPA and LPM met with licensee Toni Ferrara. Upon arrival LPA observed 2 staff members and 0 children in care. Licensee stated preschool is closed this week and will re-open January 3rd 2022.

The investigation of the above allegation consisted of children and staff interviews including LPAs observations. On 10/20/21, LPAs observed 3 staff members wearing facial coverings and providing care to 18 children in the classrooms who were not wearing facial coverings.

Furthermore, during interviews conducted with child #1, child #2, and child #3, it was disclosed that staff do wear facial coverings while inside the facility.

See complaint investigation report LIC 9099C for additional information.

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: 12/28/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/28/2021

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-20211015111156

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: BETHLEHEM LUTHERAN SCHOOL	FACILITY NUMBER: 197418346
	VISIT DATE: 12/28/2021

NARRATIVE

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

Based on observations, interviews conducted, and record review, the allegation of staff not wearing facial coverings 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.

An exit interview was conducted, a copy of this report, and notice of site visit was provided to the licensee 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: 12/28/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/28/2021

LIC9099 (FAS) - (06/04)

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