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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 300606458
Report Date: 04/01/2022
Date Signed: 04/01/2022 04:26:11 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, 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
01/18/2022 and conducted by Evaluator Alanna Gontarek
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20220118090024
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: 15DATE:
04/01/2022
UNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Alicia Barajas, TeacherTIME COMPLETED:
04:45 PM
ALLEGATION(S):
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Facility staff are not qualified
Facility staff are not trained
Facility is operating out of ratio
INVESTIGATION FINDINGS:
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On 4/01/2022 at 2:15 p.m., Licensing Program Analyst (LPA), Alanna Gontarek conducted a follow up unannounced complaint inspection on this date to the above facility for the purpose of delivering complaint investigation findings. Upon arrival LPA met with Teacher, Alicia Barajas who guided LPA on a tour of the facility. Census was taken. There were 15 preschool children and 3 staff present during this inspection. During the inspection, it was determined the facility is operating within its licensed capacity and within compliance of staffing ratios.

Information provided by the complainant alleges: 1. Facility staff are not qualified. 2. Facility staff are not trained. 3. Facility is operating out of ratio. Reporting Party (RP) stated the facility is filling staff vacancies with unqualified and untrained staff, and stated the people filling in are church members. RP also stated observed fifteen (15) children with one (1) staff member. LPA was unable to contact RP, due to reporting parting being anonymous.
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Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Patricia MaganaTELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Alanna GontarekTELEPHONE: (714) 703-2800
LICENSING EVALUATOR SIGNATURE:

DATE: 04/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/01/2022
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 5
Control Number 06-CC-20220118090024
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: FAITH LUTHERAN CHURCH EARLY LEARNING CENTER
FACILITY NUMBER: 300606458
VISIT DATE: 04/01/2022
NARRATIVE
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During the investigation, LPA conducted interviews on 1/19/22 with the Director (S1), 1 teacher (S2), and 5 children. On 2/7/22, LPA conducted interview with Assistant Director (S3). LPA also conducted interviews with 4 children’s authorized representatives. LPA obtained and reviewed the following documentation: Roster, Children’s Sign in and Sign out sheets dated 1/10/22 to 1/21/22, Employee Time sheets dated 1/10/22 to 1/21/22, staff complete files, and Personnel Report (LIC 500).

Per the allegations: Facility staff are not qualified and Facility staff are not trained. During record review of staff files, from dates 1/3/22 to 1/21/22, it was determined that S4 (church member) was missing Completion of six postsecondary semester or equivalent quarter units in early childhood education or child development. During review of the Personnnel Report (LIC 500), it states that S4’s position title is: “As needed Aid/Volunteer.” 4 staff out of 5 staff files reviewed, from 1/3/22 to 1/21/22, have completed over 12 Early Childhood Education (ECE) units. All 4 other staff files reviewed, from 1/3/22 to 1/21/22, have a current completion certificate for Mandated Reporter Training. LPA observed completion dates for CPR and First Aid, and it was found that 4 out of 5 staff have completed CPR/First Aid on 11/22/2021, expiring 11/22/2023. LPA confirmed, with training center, that the 4 staff have completed the EMSA certified 8-hour Pediatric CPR and First Aid in-person via telephone on 3/2/22 at 3:15 p.m. Based on staff file review, S4 has not completed the Mandated Reporter Training, and has no record of completing the Mandated Reporter Training on file. During interviews conducted with facility staff, S1 and S2 stated that S4 was never left alone with the children. S1, S2, and S3 stated S4 was used to fill vacancies for absent teachers, and S4 was used during naptime while teachers were on their lunch breaks. LPA confirmed that S4 was alone with the children on 1/20/22 and 1/21/22 from 1:00 p.m. to 2:00 p.m. while reviewing staff timesheets. S1, S2, and S3 stated that there were no other substitutes used. During interviews conducted with 4 children’s authorized representatives, 1 of the 4 children’s authorized representatives were satisfied with the Child Care Center. 2 out 3 children’s authorized representatives made no disclosures. 2 out of 4 children’s authorized representatives stated there was a lack of communication with staff, lack of activities for the children, and school was unorganized. It was also determined facility staff member (S4) did not have Teacher Aid qualifications nor proper training.

It was revealed, during interviews conducted with staff, that S1 has been out on leave since August of 2018. Per S1, S1 has only returned to the school to help with administrative functions and payroll. S1 also disclosed

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

DATE: 04/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/01/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 06-CC-20220118090024
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: FAITH LUTHERAN CHURCH EARLY LEARNING CENTER
FACILITY NUMBER: 300606458
VISIT DATE: 04/01/2022
NARRATIVE
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that S1 worked as a Teacher in the Pre-K classroom in the mornings and worked as the Director is the afternoons. Assistant Director (S3) stated has been acting as Director and Teacher since S1 has been out on leave, and does not know when the Director will return. During record review, LPA observed the Personnel Report (LIC 500) to state that S1’s position at the school was Director/Teacher, and S3’s position at the school was Assistant Director/Teacher. Although S3 assumed responsibility of the Director once S1 left on leave, it was determined that the facility did not have a full-time Director.
On 1/19/22, LPA attempted to interview 5 children, but was only able to interview 3 of the 5 children. LPA was unable to qualify the other 2 children, due to being non-verbal, and/or non-responsive. During interviews conducted with verbal children, when asked about church staff coming into the classroom, C2 stated that there is one man that sings in the church and there's one woman but doesn’t know woman’s name. C3 and C4 gave no response when asked about church members. The children’s statements were inconsistent, however all children stated there are at least 2 staff members present inside the classroom.
Pertaining to the allegation: Facility is operating out of ratio. During review of staff and children’s records on 1/18/22, there were a total of 14 Preschool children present on 1/18/22. It was revealed, during review of Children’s Sign In and Out sheets and Staff Time sheets, that S2 was alone supervising 13 Preschool children at 9:00 a.m., and at 9:20 a.m., S2 received her 14th Preschool child. S4 did not arrive to the facility until 10:45 a.m. From 9:00 a.m. to 10:45 a.m., facility was out of teacher-child ratio. Although staff interviewed denied being out of ratio, based on verification of documentation provided from the children’s sign in and sign out sheet and the staff schedule, the facility was found to be operating out of ratio. It was also determined facility staff member (S4) did not have Teacher Aid qualifications nor proper training. Based on staff records reviewed, the preponderance of evidence standard has been met, therefore the above allegations are found to be Substantiated. California Code of Regulations, Title 22 are being cited on the attached LIC 9099D.
Upon receipt of this report, the licensee shall post any licensing report documenting a type “A” citation. This must remain posted for 30 days during hours of operation. In addition to posting this report, the licensee will also provide copies to the parents of the children in care for up to one year. LPA provided LIC 9224 form.
Exit interview conducted with facility representative, Alicia Barajas. A copy of this report and the Appeal Rights (LIC 9058 FAS 01/16) were given and explained. Licensee’s signature on this form acknowledges receipt of these rights. A Confidential Names list (LIC811) was provided during this visit. The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site inspection by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.
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SUPERVISOR'S NAME: Patricia MaganaTELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Alanna GontarekTELEPHONE: (714) 703-2800
LICENSING EVALUATOR SIGNATURE:

DATE: 04/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/01/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 06-CC-20220118090024
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: FAITH LUTHERAN CHURCH EARLY LEARNING CENTER
FACILITY NUMBER: 300606458
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/01/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/04/2022
Section Cited
CCR
101216.3(a)
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Teacher-Child Ratio: (a) "There shall be a ratio of one teacher visually observing and supervising no more than 12 children in attendance."
This requirement was not met as evidenced by: Based on during review of Children’s Sign In and Out sheets and Staff Time sheets on 1/18/22, S2 was alone supervising 13 Pre-
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Facility was in ratio during visit today, 4/1/22. Per Director, will only be the Director, and no longer a teacher. LPA obtained declaration from DIrector. Per Director, will post an add for employment for one to 2 staff. Per Director, will submit ad to LPA on 4/4/22 and apply for CalCareers as a substitute agency to fill vacancies. Director will submit
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school children at 9:00 a.m., and at 9:20 a.m., S2 received her 14th Preschool child. S4 did not arrive to the facility until 10:45 a.m. From 9:00 a.m. to 10:45 a.m., S2 was alone with 14 children. This poses an immediate health and safety risk to the children in care.
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via email to LPA. Per Director, will submit LIC 9224 completed forms for each child attending via email.
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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: 04/01/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/01/2022
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 06-CC-20220118090024
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: FAITH LUTHERAN CHURCH EARLY LEARNING CENTER
FACILITY NUMBER: 300606458
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/01/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/15/2022
Section Cited
CCR
101216.2(d)
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Teacher Aide Qualifications and Duties: (d) An aide assisting a fully qualified teacher... in the supervision... preschool-age children...shall meet the following requirements:(1)Completion of six postsecondary semester or equivalent quarter units in early childhood education or child development semester or quarter units
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Per DIrector, will complete an LIC 500 form with updates of current staff and position titles. LPA obtained declaration stating will not use church staff unless are qualified via Title 22. Per Drector, will organize forms/files/records and office space and by the due date 4/15/22. Per Director, will submit photo of office space and files. Per Director, will
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This requirment is not met as evidenced by: Based on record review, LPA observed S4 did not have 6 ECE units. This poses a potential health and safety risk to children in care.
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create a Title 22 book, and review Title 22 regulations.
Type B
04/15/2022
Section Cited
CCR
1596.8662
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On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete
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Per Director, will not use S4 as a staff member. LPA obtained a declaration. Per Director, will conduct a staff training with all new staff and will submit Agenda notes and staff signatures by the due date of 4/15/22. This training is available on the Department's website at www.ccld.ca.gov under online Mandated Reporter Training
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renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement was not met evidenced by LPA did not see any proof of training certificate for the S4. This poses a potential risk to the health and safety of 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: 04/01/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/01/2022
LIC9099 (FAS) - (06/04)
Page: 5 of 5