300606476-5-24-2023-06-CC-JHAN-CSKT98-20230607143130

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 300606476
Report Date: 05/24/2023
Date Signed: 05/24/2023 03:42:12 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 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
05/18/2023 and conducted by Evaluator Anna Francesca Chan

COMPLAINT CONTROL NUMBER: 06-CC-20230518090934

FACILITY NAME:	GRACE HARBOR CHURCH AND SCHOOL		FACILITY NUMBER:	300606476
ADMINISTRATOR:	REBEKAH BAY		FACILITY TYPE:	830
ADDRESS:	12881 NEWPORT AVENUE		TELEPHONE:	(714) 544-4431
CITY:	TUSTIN	STATE: CA	ZIP CODE:	92780
CAPACITY:	16	CENSUS: 10	DATE:	05/24/2023
		UNANNOUNCED	TIME BEGAN:	03:30 PM
MET WITH:	Rebekah Bay, Director		TIME COMPLETED:	04:30 PM

ALLEGATION(S):

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Day care child sustained unexplained injuries while in care.

INVESTIGATION FINDINGS:

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On 05/24/2023, Licensing Program Analysts (LPAs) Chan and Tran conducted an in-person investigation to deliver findings regarding the above complaint allegation. LPAs met with Director Rebekah Bay and conducted a tour of the facility, and census was taken. Observed at the time of the visit was a total of 10 infant children and 3 staff members.

A review of the Facility Personnel Report Summary on 05/24/2023 indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

On 05/16/2023, the regional office received a complaint alleging, facility day care child sustained unexplained injuries.

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Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Rina Lopez
LICENSING EVALUATOR NAME: Anna Francesca Chan
LICENSING EVALUATOR SIGNATURE:	DATE: 05/24/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2023

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-20230518090934

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: GRACE HARBOR CHURCH AND SCHOOL	FACILITY NUMBER: 300606476
	VISIT DATE: 05/24/2023

NARRATIVE

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During the investigation on 05/18/23, LPA Chan conducted observation of children in care, reviewed incident reports, and interviewed facility staff. On 05/19/23 and 05/22/23 phone interviews with parents were conducted.

On 05/18/23, during observation, LPA assessed no outward visible injuries to 9 infant children in care.

On 05/18/23, 3 of 3 facility staff were interviewed regarding allegation. Staff interviewed stated they were not aware of any unexplained injuries sustained by any day care children. For any injury that occurs a notification is sent to parents through Procare app or by text message.

On 05/19/23 and 05/22/23, LPA attempted to interview via phone call 8 parents. 5 of the 8 parents responded and no concerns related to the allegation.

Children were not interviewed to age and being non-verbal.

Due to inconsistent statements obtained or information did not corroborate allegations, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is UNSUBSTANTIATED.

In the areas that were evaluated, NO deficiencies were observed of the California Code of Regulations, Title 22, Division 12 at the time of the visit.

Exit interview was conducted. The Notice of Site Visit was posted. Facility Director Rebekah Bay 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) and their signature on this form acknowledges receipt of these rights.” This report LIC 9099 was provided to the director. First level appeal is to Regional Manager, address is above on the report.

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SUPERVISORS NAME: Rina Lopez
LICENSING EVALUATOR NAME: Anna Francesca Chan
LICENSING EVALUATOR SIGNATURE:	DATE: 05/24/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2023

LIC9099 (FAS) - (06/04)

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