330909158-5-10-2022-10-CC-SHUK-CEDVHM-20220513162721

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 330909158
Report Date: 05/10/2022
Date Signed: 05/10/2022 11:00:11 AM

Substantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/06/2022 and conducted by Evaluator Alaina Wilburn

PUBLIC

COMPLAINT CONTROL NUMBER: 10-CC-20220506125627

FACILITY NAME:	BUNDY CANYON CHRISTIAN SCHOOL		FACILITY NUMBER:	330909158
ADMINISTRATOR:	PHYLLIS WALKER		FACILITY TYPE:	850
ADDRESS:	23411 BUNDY CANYON ROAD		TELEPHONE:	(951) 674-1254
CITY:	WILDOMAR	STATE: CA	ZIP CODE:	92595
CAPACITY:	60	CENSUS: 29	DATE:	05/10/2022
		UNANNOUNCED	TIME BEGAN:	08:00 AM
MET WITH:	Phillip Walker		TIME COMPLETED:	10:20 AM

ALLEGATION(S):

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Staff are not monitoring boys restroom.

INVESTIGATION FINDINGS:

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At 8:00am on May 10, 2022, Licensing Program Analyst (LPA) Alaina Wilburn conducted an unannounced 10 day complaint visit. LPA met with Principal Phillip Walker, to discuss the above stated allegation.

Investigation consisted of; a tour of the Red Building and observation of the Girls and Boys restroom. Also, LPA interviewed 3 Staff regarding allegation. LPA observed 22 children, 2 Teachers and 3 Aides present at time of visit. Both restrooms have 2 toilets and 2 sinks.

On 05/06/2022, a complaint allegation was received by the Community Care Licensing (CCL) office that Staff are not monitoring boys restroom. By Staff admission, LPA observed there continues to be a deficits in the supervision of the boys restroom in the red building. This incident is occurring in the transitional period, when children return to the classroom from outdoor play. The children are rushing indoors to wash their hands and at times the boys restroom will be crowded with a line. On 05/05/22, a parent observed 4 boys go into the restroom and play around without any supervision. At time of complaint, staff acknowledge that there have

Substantiated

Estimated Days of Completion: 30

SUPERVISOR'S NAME: Stephanie Hudak	TELEPHONE: (951) 320-2021
LICENSING EVALUATOR NAME: Alaina Wilburn	TELEPHONE: (951) 255-9024
LICENSING EVALUATOR SIGNATURE:	DATE: 05/10/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2022

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 10-CC-20220506125627

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: BUNDY CANYON CHRISTIAN SCHOOL	FACILITY NUMBER: 330909158
	VISIT DATE: 05/10/2022

NARRATIVE

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been up to four boys lined up in the restroom at the same time to wash their hands. While Staff state they are close by, they also acknowledge they are constantly advising the children not to crowd the restroom and they need to develop a better system to control and supervise the restrooms.

Based on interviews conducted and LPAs observation, the preponderance of evidence standard has been met and the allegation that staff are not monitoring the boys restroom is found to be SUBSTANTIATED. The facility is being cited in accordance with Title 22 Child Care Center Regulations, Division 12, Chapter 1, Section 101229(a)(1): Responsibility for Providing Care and Supervision. This posed an immediate risk to the health, safety or personal rights risk to the children in care. See LIC9099D for cited deficiency.

Exit interview conducted. A copy of this report and appeal rights were discussed and provided to the Principal Phillip Walker on this date.

If a civil penalty has been assessed during this inspection, payment is due when billed and the check(s) or money orders shall be made payable to the “California Department of Social Services”. You will receive an invoice in the mail. Do not send money until you receive your invoice. Do not send cash.

A NOTICE OF SITE VISIT WAS ISSUED AND LPA VERIFIED THAT IT WAS POSTED IN A PROMINENT LOCATION AT THE FACILITY BEFORE LEAVING. THE LICENSEE UNDERSTANDS THAT IT MUST REMAIN POSTED FOR THE NEXT 30 DAYS.

SUPERVISOR'S NAME: Stephanie Hudak	TELEPHONE: (951) 320-2021
LICENSING EVALUATOR NAME: Alaina Wilburn	TELEPHONE: (951) 255-9024
LICENSING EVALUATOR SIGNATURE:	DATE: 05/10/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2022

LIC9099 (FAS) - (06/04)

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Control Number 10-CC-20220506125627

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: BUNDY CANYON CHRISTIAN SCHOOL	FACILITY NUMBER: 330909158
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/10/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 05/18/2022 Section Cited CCR 101229(a)(1)	1 2 3 4 5 6 7	Responsibility for Providing Care and Supervision (a) The licensee shall provide care and supervision as necessary to meet the children's needs. (1) No child(ren) shall be left without the supervision of a teacher at any time... Supervision shall include visual observation. This requirement is not met as evidence by:	1 2 3 4 5 6 7	Licensee will submit a written plan of action detailing how the Teachers and Aides will actively supervise children, to ensure these potential incidents don't happen. The plan is due to LPA by plan of correction date of 05/18/2022. CIVIL PENALTIES ASSESSED today due to a subsequent violation within 12 months.*
	8 9 10 11 12 13 14	Based on interviews conducted and LPAs observation, staff failed to properly supervise children on 05/05/22, where a parent observed 4 boys in the restroom unsupervised, which poses a potential health, safety or personal rights risk to children in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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: Stephanie Hudak	TELEPHONE: (951) 320-2021
LICENSING EVALUATOR NAME: Alaina Wilburn	TELEPHONE: (951) 255-9024
LICENSING EVALUATOR SIGNATURE:	DATE: 05/10/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2022

LIC9099 (FAS) - (06/04)

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