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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 300602027
Report Date: 05/25/2021
Date Signed: 05/25/2021 03:35:00 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
03/25/2021 and conducted by Evaluator Mila Quinto
COMPLAINT CONTROL NUMBER: 06-CC-20210325163012

FACILITY NAME:SALEM LUTHERAN PRESCHOOLFACILITY NUMBER:
300602027
ADMINISTRATOR:VICKERS, KATHYFACILITY TYPE:
850
ADDRESS:6411 EAST FRANK LANETELEPHONE:
(714) 639-1946
CITY:ORANGESTATE: CAZIP CODE:
92869
CAPACITY:75CENSUS: 52DATE:
05/25/2021
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Kathy Vickers, DirectorTIME COMPLETED:
04:00 PM
ALLEGATION(S):
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Comments made related to colors believed to be racial discrimination
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Mila Quinto conducted a complaint investigation regarding the complaint allegation of comments made related to colors believed to be racial discrimination. LPA met with director, Kathy Vickers. The Covid-19 Emergency Response questionnaires were asked. LPA observed the following: Room B5 8 children and 1 staff; Room A5 8 children and 1 staff; Room A2 5 children and 1 staff; Room A3 7 children and 1 staff; Room A4 8 children and 1 staff; Room A6 8 children and 1 staff.

A review of the Facility Personnel Report on this date (5/25/2021) indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Rina LopezTELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Mila QuintoTELEPHONE: (714) 293-6471
LICENSING EVALUATOR SIGNATURE:

DATE: 05/25/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/25/2021
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 5
Control Number 06-CC-20210325163012
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: SALEM LUTHERAN PRESCHOOL
FACILITY NUMBER: 300602027
VISIT DATE: 05/25/2021
NARRATIVE
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The complainant alleged comments made related to colors believed to be racial discrimination. On 4/1/2021 and today’s visit, LPA interviewed 10 staff members which includes the director and 6 preschool children. The 9 of the 10 staff stated they have not witnessed anyone make any racial comments nor referenced to racial discrimination. The 6 children interviewed did not indicate hearing any inappropriate comments.

Although the allegation may have happened or is valid, the Department was not able to determine the alleged complaint of racial comments or referenced to racial discrimination. There was not enough preponderance of evidence, therefore the allegation is unsubstantiated.

All appeals must be in writing and received by the Licensing office within 15 business days. The facility representative was informed that the “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 LopezTELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Mila QuintoTELEPHONE: (714) 293-6471
LICENSING EVALUATOR SIGNATURE:

DATE: 05/25/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/25/2021
LIC9099 (FAS) - (06/04)
Page: 5 of 5