304370423-3-9-2022-06-CC-PMAA-CCX8GV-20220327223057

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 304370423
Report Date: 03/09/2022
Date Signed: 03/09/2022 11:05:12 AM

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
01/25/2022 and conducted by Evaluator Stella Gutierrez

PUBLIC

COMPLAINT CONTROL NUMBER: 06-CC-20220125152736

FACILITY NAME:	ST. MARK COMMUNITY PRESCHOOL		FACILITY NUMBER:	304370423
ADMINISTRATOR:	BRIMER, STAR		FACILITY TYPE:	850
ADDRESS:	2200 SAN JOAQUIN HILLS ROAD		TELEPHONE:	(949) 644-1442
CITY:	NEWPORT BEACH	STATE: CA	ZIP CODE:	92660
CAPACITY:	72	CENSUS: 0	DATE:	03/09/2022
		UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Star Brimer		TIME COMPLETED:	11:20 AM

ALLEGATION(S):

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Personal Rights- Exemptions to mask mandates are not valid.

INVESTIGATION FINDINGS:

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On 3/09/2022 at 9:00 AM Licensing Program Analyst, Stella Gutierrez arrived at St. Mark Community
preschool for the purpose to deliver findings of a complaint that was received for the above allegation on
01/25/2022. LPA, Gutierrez met with Star Brimer, Director who was explained the reason for today's visit. LPA
observed 15 preschool staff and 0 preschool children present today. Facility is closed to students today for parent teacher conferences. All adults observed have a criminal record clearance and associated to the facility.

On 01/27/2022 during an unannounced complaint investigation inspection LPA, Gutierrez observed 20 children
not wearing face coverings (ages 2 - 5 1/2) while indoors at the facility. Director stated that all 20 of the children have medical exemption that were provided by the parents or caregiver. LPA, Gutierrez reviewed C#1-C#20 file for the exemptions that were provided in each child's file.

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Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Patricia Magana	TELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Stella Gutierrez	TELEPHONE: (714) 293-5262
LICENSING EVALUATOR SIGNATURE:	DATE: 03/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2022

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-20220125152736

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: ST. MARK COMMUNITY PRESCHOOL	FACILITY NUMBER: 304370423
	VISIT DATE: 03/09/2022

NARRATIVE

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Based on observation and records review 16 out of the 20 exemptions reviewed by LPA are not valid in
accordance to the guidance requirements by California Department of Public Health. When assessing an
exemption due to a medical condition, mental health condition, disability that prevents wearing a mask, or
hearing impairment is a medical determination and therefore must be made by a physician (M.D. or D.O.),
nurse practitioner (N.P.), or physician assistant (P.A.). Additionally, persons exempted from wearing a face
covering due to a medical condition, must wear a non-restrictive alternative, such as a face shield with a drape on the bottom edge, as long as their condition permits it. The 16 mask exceptions on file, were signed by a Clinical Psychologist. The administrator failed to follow the mask mandates and guidance provided from CDPH for the Use of Face Coverings issued by the California Department of Public Health (CDPH) issued on June 11, 2021 Referencing updates and clarification provided by healthcare officials of additional requirements to exemptions:https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/Schools-FAQ.aspx, this is an immediate health risk to the children in care.

The allegations of Personal Rights will be substantiated. A substantiated finding means that the complaint is
substantiated, and the allegation is valid because the preponderance of the evidence standard has been met.
The following violation was revealed and is being cited in accordance with California Code of Regulations,
Title 22, Division 12, Chapter 1, article 6, Section 101223 (a)(2) , is being cited on the attached 9099 (D).

Exit interview conducted and report was reviewed with the Director, Star Brimer. 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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SUPERVISOR'S NAME: Patricia Magana	TELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Stella Gutierrez	TELEPHONE: (714) 293-5262
LICENSING EVALUATOR SIGNATURE:	DATE: 03/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2022

LIC9099 (FAS) - (06/04)

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Control Number 06-CC-20220125152736

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: ST. MARK COMMUNITY PRESCHOOL	FACILITY NUMBER: 304370423
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/09/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 03/10/2022 Section Cited CCR 101223(a)(2)	1 2 3 4 5 6 7	101223 Personal Rights (a) The licensee shall ensure that each child is accorded the following personal rights: 2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs. This requirement was not met as evidence	1 2 3 4 5 6 7	Director will submit proof of communications to the parents or authorized representatives of the requirements of an exemption for their child(ren)to be medically exempt from wearing face coverings while indoors at St. Mark Community Preschool Please inform parents that exemptions must be signed and provided
	8 9 10 11 12 13 14	by records review 16 / 20 exemptions provided in childres files are not valid to follow the mandate of CDPH mentioned on page 2 of the complaint finidings 9099 (c). medical determination and therefore must be made by a physician (M.D. or D.O.), nurse practitioner (N.P.), or physician assistant (P.A.)	8 9 10 11 12 13 14	by one of the following: a physician (M.D. or D.O.), nurse practitioner (N.P.), or physician assistant (P.A.) and any current exemptions that are not provided by the above mentioned is not valid and will not be valid. Director will submit this requirement to LPA, Gutierrez via email to stella.gutierrez@dss.ca.gov by 03/10/2022 by 5:00PM.
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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 Magana	TELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Stella Gutierrez	TELEPHONE: (714) 293-5262
LICENSING EVALUATOR SIGNATURE:	DATE: 03/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2022

LIC9099 (FAS) - (06/04)

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