300600390-12-21-2021-06-CC-RLOZ-CAUQ4B-20220120105003

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 300600390
Report Date: 12/21/2021
Date Signed: 12/21/2021 01:27:55 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/21/2021 and conducted by Evaluator Pat Rivas

PUBLIC

COMPLAINT CONTROL NUMBER: 06-CC-20211021103440

FACILITY NAME:	GOOD SHEPHERD PRE SCHOOL		FACILITY NUMBER:	300600390
ADMINISTRATOR:	ALVAREZ-MACKOW, BERNADETTE		FACILITY TYPE:	850
ADDRESS:	7082 CRESCENT AVENUE		TELEPHONE:	(714) 827-6440
CITY:	BUENA PARK	STATE: CA	ZIP CODE:	90620
CAPACITY:	74	CENSUS: 17	DATE:	12/21/2021
		UNANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Kristy Farmer, Lead Teacher		TIME COMPLETED:	12:45 PM

ALLEGATION(S):

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Preschool Teacher was screaming at another Preschool teacher in front of children in care

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) P Rivas conducted an unannounced complaint visit to render findings for the above allegation. Upon arrival LPA met with Kristy Farmer, Lead Teacher
There were 4 teachers in 3 classrooms with a total of 17 children. Based upon LPA’s observation Licensee is operating within the licensed capacity as specified on license.

A review of the Facility Personnel Report Summary and staff files on this date 12/21/21 at 12:31PM indicated all facility staff present or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

The investigation consisted of Staff file reviews; Interviews with parents, children and teachers.

It was alleged that Staff#1(S1) screamed at S2 in front of the children on 10/21/21. LPA conducted staff and children interviews on 10/22/21. LPA interviewed six qualified children who were present when alleged

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Pat Rivas	TELEPHONE: 714-703-2800
LICENSING EVALUATOR SIGNATURE:	DATE: 12/21/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2021

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 06-CC-20211021103440

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: GOOD SHEPHERD PRE SCHOOL	FACILITY NUMBER: 300600390
	VISIT DATE: 12/21/2021

NARRATIVE

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incident happened . All children interviewed could not recall any staff screaming, all children reported feeling safe. All staff denied screaming at anyone. Three of four staff interviewed reported they had not witnessed any staff screaming at anyone.
Interviews with five of five parents indicated they had no issues or concerns with the care being provided.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is unsubstantiated.

An exit interview was conducted with designee. Appeal Rights were explained. The Director was provided a copy of appeal rights (LIC 9058) 01/16) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days. First level appeals should be sent to the Regional Manager to the address listed.

The Notice of Site Visit was given and discussed it must be posted as required by H & S Code Sec. 1596.817. Notice of Site Visit must be posted for 30 consecutive days. Failure to post will result in civil penalties of $100.00.

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Pat Rivas	TELEPHONE: 714-703-2800
LICENSING EVALUATOR SIGNATURE:	DATE: 12/21/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2021

LIC9099 (FAS) - (06/04)

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