334830314-1-12-2023-10-CC-CMAZ-CN6R34-20230117113919

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 334830314
Report Date: 01/12/2023
Date Signed: 01/12/2023 01:24:53 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, 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
12/06/2022 and conducted by Evaluator Alaina Wilburn

PUBLIC

COMPLAINT CONTROL NUMBER: 10-CC-20221206082031

FACILITY NAME:	PRINCE OF PEACE LUTHERAN PRESCHOOL		FACILITY NUMBER:	334830314
ADMINISTRATOR:	LILAH WHEELER		FACILITY TYPE:	850
ADDRESS:	701 N. SANDERSON AVENUE		TELEPHONE:	(951) 925-9798
CITY:	HEMET	STATE: CA	ZIP CODE:	92545
CAPACITY:	82	CENSUS: 31	DATE:	01/12/2023
		UNANNOUNCED	TIME BEGAN:	12:45 PM
MET WITH:	Lucy Coronado		TIME COMPLETED:	01:35 PM

ALLEGATION(S):

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Licensee allows unqualified staff to work at facility

INVESTIGATION FINDINGS:

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At 12:45PM on January 12, 2023, Licensing Program Analyst (LPA) Alaina Wilburn conducted an unannounced complaint visit. LPA met with Director Lucy Coronado, to deliver findings on the above stated allegation.

Investigation consisted of: a review of the Personnel Report (LIC 500), all personnel records and qualifications.

On 12/06/2022, a complaint allegation was received by the Community Care Licensing (CCL) office that Licensee allows unqualified staff to work at facility. During the initial visit on 12/07/22, LPA reviewed eight personnel records. LPA observed Staff #1 (S1) and Staff #2 (S2) were hired as Assistant Teachers, Staff #3 (S3) was hired as a preschool Teacher, and none of the personnel records had transcripts, proof of completion of required units or enrollment in an accredited college/university at time of visit. Based on records review and LPAs observation, the preponderance of evidence standard has been met and the

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Stephanie Hudak	TELEPHONE: (951) 320-2021
LICENSING EVALUATOR NAME: Alaina Wilburn	TELEPHONE: (951) 255-9024
LICENSING EVALUATOR SIGNATURE:	DATE: 01/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/12/2023

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 10-CC-20221206082031

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: PRINCE OF PEACE LUTHERAN PRESCHOOL	FACILITY NUMBER: 334830314
	VISIT DATE: 01/12/2023

NARRATIVE

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allegation that Licensee allows unqualified staff to work at facility is found to be SUBSTANTIATED. The facility is being cited in accordance with Title 22 Child Care Center Regulations, Division 12, Chapter 1, Section 101216.1: Teacher Qualification and Duties and 101216.2: Teacher Aide Qualification and Duties. This poses a potential risk to the health, safety, or personal rights 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 Director Lucy Coronado on this date.

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: 01/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/12/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 10-CC-20221206082031

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: PRINCE OF PEACE LUTHERAN PRESCHOOL	FACILITY NUMBER: 334830314
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/12/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 01/27/2023 Section Cited CCR 101216.1(b)	1 2 3 4 5 6 7	Teacher Qualifications and Duties(b) Prior to employment, a teacher shall meet the requirements of (b)(1) or (b)(2) below: The requirement is not met as evidenced by	1 2 3 4 5 6 7	Director advised she will make sure staff have everything in place before they start, and obtain an original copy of the transcripts. Staff # is no longer working for the facility. No further action required
	8 9 10 11 12 13 14	During the course of this investigation, LPA Wilburn observed Staff #3 was hired and worked at the facility for about a month without providing proof of qualifications, which poses/posed a potential health, safety or personal rights risk to children in care.	8 9 10 11 12 13 14
Type B 01/27/2023 Section Cited CCR 101216.2(d)	1 2 3 4 5 6 7	Teacher Aide Qualifications and Duties (d) An aide assisting a fully qualified teacher in the supervision of up to 18 preschool-age children... shall meet the following requirements: Completion of six... in early childhood education or child development, or	1 2 3 4 5 6 7	Director advised she will make sure staff have everything in place before they start, and obtain an original copy of the transcripts. Staff # is no longer working for the facility. Corrective paperwork received today
	8 9 10 11 12 13 14	The requirement is not met as evidenced by: LPA Wilburn observed Staff #1 and Staff #2 were hired as a Assistant Teacher without proof of qualifications or enrollment at an accredited college/university at time of visit, which poses/posed a potential health, safety or personal rights risk to children in care.	8 9 10 11 12 13 14

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: 01/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/12/2023

LIC9099 (FAS) - (06/04)

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