370806232-12-13-2023-51-CC-RASW-CZ667L-20240103193339

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 370806232
Report Date: 12/13/2023
Date Signed: 12/13/2023 11:45:19 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, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/16/2023 and conducted by Evaluator Adrian L Mangina

PUBLIC

COMPLAINT CONTROL NUMBER: 51-CC-20231016114916

FACILITY NAME:	SAINT DAVID'S PRESCHOOL		FACILITY NUMBER:	370806232
ADMINISTRATOR:	KAREN GARCIA		FACILITY TYPE:	850
ADDRESS:	5050 MILTON STREET		TELEPHONE:	(619) 276-7048
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92110
CAPACITY:	53	CENSUS: 31	DATE:	12/13/2023
		UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Karen Garcia		TIME COMPLETED:	11:45 AM

ALLEGATION(S):

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Facility staff did not notify responsible party of daycare child's injury in a timely manner.

INVESTIGATION FINDINGS:

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On 12/13/23 at 11:00 AM Licensing Program Analyst (LPA) Adrian Mangina conducted an unannounced inspection for the purpose of delivering findings for the complaint received on 10/16/23, regarding the above allegation. LPA met with Director, Karen Garcia. Also present in the facility were 31 daycare children with 5 teachers supervising outside and in the bathroom. Proper ratios and supervision were observed.

It was alleged that the facility did not notify responsible party of daycare child's injury in a timely manner. On 9/22/23 at approximately 2:00 PM a child was found to have blood present during a diaper change. Child’s authorized representative was sent an email at 6:42 PM that evening reporting the incident. Consensus among staff and witnesses is that the norm is to contact responsible parties immediately or as soon as possible generally by phone or text when a serious injury occurs and, if the injury occurs prior to

continued on LIC9099 page 2

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Renesha Askew	TELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Adrian L Mangina	TELEPHONE: (619) 629-6197
LICENSING EVALUATOR SIGNATURE:	DATE: 12/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2023

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 5

Control Number 51-CC-20231016114916

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: SAINT DAVID'S PRESCHOOL	FACILITY NUMBER: 370806232
	VISIT DATE: 12/13/2023

NARRATIVE

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LIC9009 page 2

3:00 PM, to provide an “incident report” to parents by pick up that same day. Based on the information obtained during interviews, observations, and documentation reviewed it is determined that because responsible party was not informed immediately nor at pick up during the customary time, thereby the report was not in the usual fashion, causing the message to not be received until the next day and thus responsible party did not understand the seriousness of the injury and was unable to seek immediate medical care.

The allegation is valid because the preponderance of the evidence has been met, therefore, the above allegation is found to be SUBSTANTIATED. The deficiency is being cited on the attached LIC 9099D.
The Notice of Site Visit was provided, and LPA observed posting. Licensee is advised it must remain posted for 30 days.

SUPERVISOR'S NAME: Renesha Askew	TELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Adrian L Mangina	TELEPHONE: (619) 629-6197
LICENSING EVALUATOR SIGNATURE:	DATE: 12/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2023

LIC9099 (FAS) - (06/04)

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Control Number 51-CC-20231016114916

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: SAINT DAVID'S PRESCHOOL	FACILITY NUMBER: 370806232
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 12/13/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 12/28/2023 Section Cited CCR 101226(a)	1 2 3 4 5 6 7	HEALTH RELATED SERVICES: 101226(a):...licensee shall immediately notify the child's authorized representative if the child... sustains an injury more serious ... licensee shall obtain specific instructions from authorized representative regarding action ...taken.	1 2 3 4 5 6 7	Licensee states discusssed reporting procedure with staff on 11/22/23 and reviewed ouch report policy and ccld website videos regarding reporting requirements and provided LIC624 to staff. Licensee provided LPA with training sign in sheet during the visit.
	8 9 10 11 12 13 14	Based on the information obtained during interviews, observations, and documentation reviewed it is determined that facility staff did not immediately report the injury of child 1 to responsible party which posed 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: Renesha Askew	TELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Adrian L Mangina	TELEPHONE: (619) 629-6197
LICENSING EVALUATOR SIGNATURE:	DATE: 12/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 5

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/16/2023 and conducted by Evaluator Adrian L Mangina

PUBLIC

COMPLAINT CONTROL NUMBER: 51-CC-20231016114916

FACILITY NAME:	SAINT DAVID'S PRESCHOOL		FACILITY NUMBER:	370806232
ADMINISTRATOR:	KAREN GARCIA		FACILITY TYPE:	850
ADDRESS:	5050 MILTON STREET		TELEPHONE:	(619) 276-7048
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92110
CAPACITY:	53	CENSUS: 31	DATE:	12/13/2023
		UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Karen Garcia		TIME COMPLETED:	11:45 AM

ALLEGATION(S):

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Lack of supervision resulted in child sustaining injury while in care

INVESTIGATION FINDINGS:

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On 12/13/23 at 11:00 AM Licensing Program Analyst (LPA) Adrian Mangina conducted an unannounced inspection for the purpose of delivering findings for the complaint received on 10/16/23, regarding the above allegation. LPA met with Director, Karen Garcia. Also present in the facility were 31 daycare children with 5 teachers supervising outside and in the bathroom. Proper ratios and supervision were observed.

It was alleged that on 9/22/23 child 1 sustained an injury at the facility due to lack of supervision. The child arrived at the facility at an undetermined time in the morning as child was not signed in that day as required. During the third diaper change of the day, first bowel movement, at 2:00 PM blood was found in the diaper area. Witnesses claimed to have not seen the child fall or hurt themselves that day. Responsible party also claimed to have not seen the child hurt themselves. LPA interviewed all pertinent parties and none witnessed
an incident that could have caused the injury. Responsible party did not take the child for medical treatment

continued on LIC9099-A page 2

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Renesha Askew	TELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Adrian L Mangina	TELEPHONE: (619) 629-6197
LICENSING EVALUATOR SIGNATURE:	DATE: 12/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 4 of 5

Control Number 51-CC-20231016114916

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: SAINT DAVID'S PRESCHOOL	FACILITY NUMBER: 370806232
	VISIT DATE: 12/13/2023

NARRATIVE

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LIC9099-A page 2

until 13 days after the incident was reported. Based on the information obtained during interviews, observations, and documentation reviewed LPA was unable to determine with a preponderance of evidence that the injury was incurred at the facility.

Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred, therefore the above allegation is found to be Unsubstantiated.

Exit interview conducted and report was reviewed with facility representative, Karen Garcia. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100

SUPERVISOR'S NAME: Renesha Askew	TELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Adrian L Mangina	TELEPHONE: (619) 629-6197
LICENSING EVALUATOR SIGNATURE:	DATE: 12/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2023

LIC9099 (FAS) - (06/04)

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