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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 336300022
Report Date: 08/17/2022
Date Signed: 08/17/2022 03:39:42 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
08/11/2022 and conducted by Evaluator Lorena Valenzuela
PUBLIC
COMPLAINT CONTROL NUMBER: 10-CC-20220811104312
FACILITY NAME:LITTLE LAMB'S PRESCHOOLFACILITY NUMBER:
336300022
ADMINISTRATOR:AMY-RUTH BOCKMANFACILITY TYPE:
850
ADDRESS:21901 RAILROAD CANYON RDTELEPHONE:
(951) 471-3807
CITY:LAKE ELSINORESTATE: CAZIP CODE:
92532
CAPACITY:79CENSUS: 50DATE:
08/17/2022
UNANNOUNCEDTIME BEGAN:
09:39 AM
MET WITH:Lacey Romeyn, DirectorTIME COMPLETED:
12:00 PM
ALLEGATION(S):
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Facility did not notify the Department of structural changes within the classrooms before use
INVESTIGATION FINDINGS:
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On August 17, 2022, at 9:39 AM, Licensing Program Analysts (LPA's) Lorena Valenzuela and Ana Noble conducted an unannounced complaint inspection with Little Lamb's Preschool, Director Lacey Romeyn. The purpose of the inspection was to initiate an investigation and to deliver the findings on the above stated allegation. During this inspection, LPA's toured facility, took census, verified facility staff, and interviewed the Staff #1 and Staff #2. In addition, LPA's collected copies of pertinent facility documents. Additionally, as part of the investigation, LPA Valenzuela conducted an interview with other relevant parties.

On August 11, 2022, Community Care Licensing (CCL) received information facility did not notify the Department of structural changes within the classroom before use. Confidential interviews revealed there were structural changes made to the licensed areas in the facility’s building. Interviews conducted revealed that rooms which were previously an office space and “work room”, per the facility sketch on file, where combined into a room, where the adjoining wall was removed. Confidential interviews revealed the structural changes were made a “few weeks ago” and “during the summer break”.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Stephanie Hudak
LICENSING EVALUATOR NAME: Lorena Valenzuela
LICENSING EVALUATOR SIGNATURE:

DATE: 08/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2022
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 3
Control Number 10-CC-20220811104312
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: LITTLE LAMB'S PRESCHOOL
FACILITY NUMBER: 336300022
VISIT DATE: 08/17/2022
NARRATIVE
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 Records review did not indicate the facility reported their intent to making the structural changes prior to the changes being made. In addition, LPA’s observed the room currently being identified as the “Orange” room and previously identified as the office and work room, was being used for daycare purposes at the time of the inspection.
Based on interviews, observations and records review, the preponderance of evidence standard has been met, and the allegation the facility did not notify the Department of structural changes within the classroom before use, is substantiated. The facility is being cited under Title 22, Section 101212 (c) Reporting Requirements. See deficiency report for citation cited.
An exit interview was conducted, and a copy of this report, LIC 9099-D, and appeal rights was provided to the Director Lacey Romeyn. A Notice of Site Visit was issued and posted.
SUPERVISORS NAME: Stephanie Hudak
LICENSING EVALUATOR NAME: Lorena Valenzuela
LICENSING EVALUATOR SIGNATURE:

DATE: 08/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 10-CC-20220811104312
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: LITTLE LAMB'S PRESCHOOL
FACILITY NUMBER: 336300022
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/17/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/26/2022
Section Cited
CCR
101212(c)
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101212 (c) Reporting Requirements
The licensee shall notify the Department in writing of his/her intent prior to making any structural changes...
This requirement was not met as evidence by:
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Director Lacey Romeryn agrees to submit an updated facility sketch and obtain a fire clearance for space identified as the "Orange" room . Director agrees to not use the "Orange" room for daycare until the fire clearance is obtained. POC will be submitted to the Department by due date 08/26/2022.
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Based on interviews, observations and records review, the facility did not report as required to the Department, that the facility had an intent of making structural changes to a room currently being identified as the “Orange” room. This poses a potential health, safety or personal rights risk to the 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.
SUPERVISORS NAME: Stephanie Hudak
LICENSING EVALUATOR NAME: Lorena Valenzuela
LICENSING EVALUATOR SIGNATURE:

DATE: 08/17/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 3