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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 300600217
Report Date: 12/13/2021
Date Signed: 12/13/2021 11:51:21 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:COMMUNITY CHRISTIAN PRESCHOOLFACILITY NUMBER:
300600217
ADMINISTRATOR:ROBYN DELGADOFACILITY TYPE:
850
ADDRESS:17575 EUCLID STREETTELEPHONE:
(714) 962-5414
CITY:FOUNTAIN VALLEYSTATE: CAZIP CODE:
92708
CAPACITY:84CENSUS: 27DATE:
12/13/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
08:50 AM
MET WITH:Robyn Delgado, DirectorTIME COMPLETED:
12:15 PM
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On 12/13/2021, Licensing program analyst (LPA) Tina Nguyen conducted a visit at the facility. The purpose of this visit was to conduct a Case Management Evaluation of the facility. LPA Nguyen met with the director Robyn Delgado and toured the facility inside and outside. Census was taken in individual classrooms. The overall census observed was 6 preschool staffs and 27 preschool children. A review of staff criminal clearance records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

On 12/02/2021, the Licensing Office received a self-report an unusual incident. The facility filed Unusual Incident Report (UIR) stating that parent of Child #1 (C1) told the director that on Wednesday 12/01/2021, during bath time at home, C1’s sibling noticed a red mark/cut on C1’s private part. C1 told her parent that Child #2 (C2) did it to C1 at school. School director indicated that no one is with the name of C2 at the facility. Per parents, C1 was taken to the hospital. The doctor said it looks like an infection. The doctor reported it to Child Abuse Registry and Police. Parent showed the group class picture of C1 classroom to C1 and asked who hurt C1. C1 did not say anything. Parent showed child #3 (C3)’s classroom group picture. C1 pointed out to Child #4 (C4). Per school director, C4 was not at school on Wednesday 12/01/2021. C1 and C3 are twin and attend the school in different classroom. C4 is in the twin's classroom. Police came to the parent's house last night and asked questions.
During today’s inspection, staff interviews were conducted. Due to insufficient information available and further interviews needed with child is not present, the aforementioned allegation needs further investigation. After a tour of the facility, no deficiency observed.
Exit interview was conducted. The Notice of Site Visit was posted. Director was informed that the Notice of Site Visit must be posted for 30 consecutive days. Failure to post will result in civil penalty of $100. “The licensee was provided a copy of their appeal rights (LIC 9058 12/15) and their signature on this form acknowledges receipt of these rights.”
SUPERVISOR'S NAME: Thuy HoTELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Tina NguyenTELEPHONE: (714) 292-2922
LICENSING EVALUATOR SIGNATURE:

DATE: 12/13/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
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