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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198014862
Report Date: 05/04/2022
Date Signed: 05/04/2022 12:40:17 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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/22/2022 and conducted by Evaluator Elka Chavez
COMPLAINT CONTROL NUMBER: 54-CC-20220222151046
FACILITY NAME:CALVARY CHAPEL CHRISTIAN PRESCHOOLFACILITY NUMBER:
198014862
ADMINISTRATOR:BLANCA SANCHEZFACILITY TYPE:
850
ADDRESS:12808 WOODRUFF AVENUETELEPHONE:
(562) 299-9100
CITY:DOWNEYSTATE: CAZIP CODE:
90242
CAPACITY:95CENSUS: 89DATE:
05/04/2022
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Denisse CardenasTIME COMPLETED:
12:45 PM
ALLEGATION(S):
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Day care child left unattended
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Elka Chavez conducted an unannounced complaint inspection on May 04, 2022 at 9:30 AM. LPA met with facility representative, Denisse Cardenas to discuss the above allegation. At the time of arrival LPA observed 89 children in care with 10 staff.

During this investigation interviews were conducted with parents, staff and children.

Information from the complainant indicates that a child was left unattended in the preschool playground on January 15, 2022. During inspection, statements were provided which disclosed a child was left in the preschool playground while transitioning from the playground to the bathroom. Staff # 5 observed child #1 was not with the group as they were walking by room number 11 located in the Elementary School. During this investigation 5 out of 7 staff interviewed validated the above allegation. During this investigation 3 out of 7 staff interviewed disclosed child #1 was left unattended for approximately one to two minutes.

Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Elka ChavezTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 05/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/04/2022
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 54-CC-20220222151046
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: CALVARY CHAPEL CHRISTIAN PRESCHOOL
FACILITY NUMBER: 198014862
VISIT DATE: 05/04/2022
NARRATIVE
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Parent interviews made no disclosures regarding the above allegation. Children interviews made no disclosures regarding the above allegation

Based on interviews which were conducted and record review of the written statements, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division 12 Chapter 1 101229), are being cited on attached deficiencies page.

A notice of site visit was given and must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the Facility Representative, Denisse Cardenas.
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Elka ChavezTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 05/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/04/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 54-CC-20220222151046
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: CALVARY CHAPEL CHRISTIAN PRESCHOOL
FACILITY NUMBER: 198014862
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/04/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/16/2022
Section Cited
CCR
101229(a)(1)
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101229 Responsibility for Providing Care and Supervision ... (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.
This requirement was not met as evidenced by:
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Facility Representative, Denisse Cardenas implemented counting during any transitions is made to ensure all the children there. We will discuss Care and Supervision in our next meeting, have staff watch video and provide LPA with sign in sheet.
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Based on interviews which were conducted 5 out of 7 staff interviewed validated the allegation. During this investigation 3 out of 7 staff interviewed disclosed child #1 was left unattended for approximately one to two minutes
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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.
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Elka ChavezTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 05/04/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/04/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 3