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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198014862
Report Date: 02/23/2022
Date Signed: 02/23/2022 05:17:30 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
02/18/2022 and conducted by Evaluator Elka Chavez
COMPLAINT CONTROL NUMBER: 54-CC-20220218143953
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: 57DATE:
02/23/2022
UNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Denisse CardenasTIME COMPLETED:
05:20 PM
ALLEGATION(S):
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7
8
9
Day care children have access to hazardous item
INVESTIGATION FINDINGS:
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2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Elka Chavez conducted an unannounced complaint inspection on February 23, 2022 at 12:00 PM. LPA met with Assistant Director, Denisse Cardenas to discuss the above allegation. At the time of arrival LPA observed 57 children in care with 7 staff.

At 12:05 PM LPA observed clorox wipes in the classrooms (12,113,114,115,116,117) next to the sink used by children in care. At 12:40 LPA observed cleaning supplies stored in the cabinets above the sink in the restrooms used by preschoold children. LPA did not observe the cabinets to be locked. LPA observed Ajax, clorox spray and lysol toilet bowl cleaner. Based on LPA’s observations and interviews which were conducted, the preponderance of the evidence standard has been met, therefore the above allegation(s) is found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division 12 & Chapter 1, 101238) are being cited on the attached LIC9099D.
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: 02/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2022
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 9
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
02/18/2022 and conducted by Evaluator Elka Chavez
COMPLAINT CONTROL NUMBER: 54-CC-20220218143953

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: 57DATE:
02/23/2022
UNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:TIME COMPLETED:
05:20 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility plug outlets are not properly covered
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
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: 02/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 9
Control Number 54-CC-20220218143953
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: 02/23/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/23/2022
Section Cited
CCR
101238
1
2
3
4
5
6
7
101238 Buildings and Grounds (g) Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children shall be stored where inaccessible to children.
The requirement is not met as evidenced by:
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7
Assistant director, Denisse stated that she will inplemement that teachers lock the cleaning supplies making them inaccessible to children in care. Keys will be requested today from the maintenance team. Make sure they walk throughs are conducted to ensure cabinets are locked. A teacher memo will go out. And alog will be created for each classroom.
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9
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12
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LPA observed clorox wipes in room 112,113,114,115,116,117 in the classroom sinks used by the preschool children. LPA observed the cabinets in the restroom used to store cleaning supplies in the restroom to be unlocked. Staff #3 stated that the church uses the rooms and they may have removed them. This poses an immediate health and safety risk to children in care.
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9
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12
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14
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2
3
4
5
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7
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7
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7
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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: Karen ChambersTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Elka ChavezTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 02/23/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 9
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
02/18/2022 and conducted by Evaluator Elka Chavez
COMPLAINT CONTROL NUMBER: 54-CC-20220218143953

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: 57DATE:
02/23/2022
UNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:TIME COMPLETED:
05:20 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility plug outlets are not properly covered
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Elka Chavez conducted an unannounced complaint inspection on February 23, 2022 at 12:00 PM. LPA met with Assistant Director, Denisse Cardenas to discuss the above allegation. At the time of arrival LPA observed 57 children in care with 7 staff.

At 12:05 PM LPA observed electrical outlets in rooms 112, 113, 114, 117 and 118 and both restrooms used by the preschool without covers. LPA was informed by staff #3 that the church also uses the rooms and they may have removed them. Based on LPA’s observations and interviews which were conducted, the preponderance of the evidence standard has been met, therefore the above allegation(s) is found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division 12 & Chapter 1, 101238) are being cited on the attached LIC9099D

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: 02/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 9
Control Number 54-CC-20220218143953
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: 02/23/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/24/2022
Section Cited
CCR
101238(a)
1
2
3
4
5
6
7
101238(a) The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors.
The requirement is not met as evidenced by:
1
2
3
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5
6
7
Assistant Director, Denisse Cardenas will purchase outlet covers tonight. A staff memo will be going to staff to remind staff to make sure that the covers are on. And signs will be posted in the outlets to remind them to place the covers back on. Director will provide proof to LPA by POC due date.
8
9
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12
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14
LPA observed electrical outlets without covers in room 112,113,114,115,116,117 and in the restroom used by the preschool children. Staff #3 stated that the church uses the rooms and they may have removed them. This poses an immediate health and safety risk to children 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: Karen ChambersTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Elka ChavezTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 02/23/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2022
LIC9099 (FAS) - (06/04)
Page: 5 of 9
Control Number 54-CC-20220218143953
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: 02/23/2022
NARRATIVE
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10
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Exit interview was conducted with Denisse Cardenas.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Elka ChavezTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 02/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2022
LIC9099 (FAS) - (06/04)
Page: 6 of 9
Control Number 54-CC-20220218143953
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: 02/23/2022
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
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25
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30
31
32
Exit interview was conducted with Director, Denisse Cardenas.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Elka ChavezTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 02/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2022
LIC9099 (FAS) - (06/04)
Page: 9 of 9