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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 300606458
Report Date: 04/12/2022
Date Signed: 04/12/2022 09:58:09 AM


Document Has Been Signed on 04/12/2022 09:58 AM - It Cannot Be Edited

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:FAITH LUTHERAN CHURCH EARLY LEARNING CENTERFACILITY NUMBER:
300606458
ADMINISTRATOR:PAESANO, CALLIEFACILITY TYPE:
850
ADDRESS:8200 ELLIS AVENUETELEPHONE:
(714) 962-1864
CITY:HUNTINGTON BEACHSTATE: CAZIP CODE:
92646
CAPACITY:53CENSUS: 13DATE:
04/12/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Alicia BarajasTIME COMPLETED:
11:00 AM
NARRATIVE
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An unannounced Case Management Deficiencies Inspection visit was conducted on this day by Licensing Program Analysts (LPAs) Alanna Gontarek and Patricia Duron based on information discovered during an inspection for an unrelated complaint investigation on 01/19/22. On today's date, LPAs met with Teacher, Alicia Barajas who guided LPAs on a tour of the facility. Census was taken. LPA observed a total of 13 preschool children and 2 staff upon arrival.

During interview conducted with the Director, Callie Paesano on 1/19/22, the Director disclosed she has been out on disability since August of 2021, and only comes into the facility to complete administrative functions. The Director stated, she can return as Director once medical clearance to return to work has been received. Director could not give a return date. Facility has been operating with no Director as of August 2021. New Director packet has not been received by the department since Director, Callie Paesano, left on leave.

Based on LPAs observations, record reviews and interviews conducted, the following violation was observed in accordance with California Code of Regulations, Title 22, Division 12, Chapter 1, 101215.1(b) Child Care Center Directors Qualifications and Duties (b) All child care centers shall have a director, and is being cited on the attached LIC 809D.

LPA Gontarek advised facility representative, Director’s packet must be submitted to the department, including all qualifying documents when there is a change of director. LPA also advised facility representative that when the child care center director is absent from the center, arrangements shall be made for a fully qualified teacher to act as substitute. This substitute child care center director shall be aware of center operations, including total enrollment; shall be trained in program operation; and shall be designated as an authorized



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SUPERVISOR'S NAME: Patricia MaganaTELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Alanna GontarekTELEPHONE: (714) 703-2800
LICENSING EVALUATOR SIGNATURE:
DATE: 04/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/12/2022
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION 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: FAITH LUTHERAN CHURCH EARLY LEARNING CENTER
FACILITY NUMBER: 300606458
VISIT DATE: 04/12/2022
NARRATIVE
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Page 2: Case Management

person to correct operational deficiencies that constitute immediate threats to children's health and safety. If the child care center director is absent for more than 30 consecutive calendar days, the substitute director shall meet the qualifications of a director.

Facility representative was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Exit interview conducted and report was reviewed with the facility representative, Alicia Barajas. Appeal Rights and deficiencies were discussed. The facility representative was provided a copy of their appeal rights (LIC 9058) 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.

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-End of Report-

SUPERVISOR'S NAME: Patricia MaganaTELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Alanna GontarekTELEPHONE: (714) 703-2800
LICENSING EVALUATOR SIGNATURE:

DATE: 04/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/12/2022
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 04/12/2022 09:58 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION 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: FAITH LUTHERAN CHURCH EARLY LEARNING CENTER
FACILITY NUMBER: 300606458

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/12/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/26/2022
Section Cited

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Child Care Center Directors Qualifications and Duties (b) All child care centers shall have a director. This requirement was not met as evidenced by: During interview conducted with the Director on 1/19/22, the Director disclosed she has been out on disability since August of 2021, and only comes into the facility to complete
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administrative functions. Facility has been operating with no Director as of August 2021. New Director packet has not been received by the department since Director, Callie Paesano, left on leave. This poses a potential health, safety, and personal rights risk to the children in care.
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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: Patricia MaganaTELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Alanna GontarekTELEPHONE: (714) 703-2800
LICENSING EVALUATOR SIGNATURE:
DATE: 04/12/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/12/2022
LIC809 (FAS) - (06/04)
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