370806232-6-4-2021-51-CC-RPAK-C4AV8G-20210624161240

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 370806232
Report Date: 06/04/2021
Date Signed: 06/04/2021 10:44:45 AM

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
04/21/2021 and conducted by Evaluator Adrian L Mangina

PUBLIC

COMPLAINT CONTROL NUMBER: 51-CC-20210421134606

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:	06/04/2021
		UNANNOUNCED	TIME BEGAN:	09:32 AM
MET WITH:	Karen Garcia		TIME COMPLETED:	10:30 AM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Child in care was left unsupervised
Staff sleeps in the classroom while children are present

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

On 6/4/21 at 9:32 AM Licensing Program Analysts (LPAs) Adrian Mangina and Keturah Lane made an unannounced complaint visit for the complaint received on 4/21/21 for the purpose of delivering findings on the above allegations. During the visit. LPAs met with Director Karen Garcia. The total census observed was 31: classroom 6 had 3 children with staff member Cindy Adams, classroom 4 had 9 children with staff members Stephanie Carr and substitute teacher's aide Mary Caulderon, classroom A had 8 children with staff member Nikkita Kemp, Classroom B had 11 children with staff member Zyntia Acosta. Facility was within ratio and capacity.

Based on the information obtained during interviews, observations, and photographic evidence obtained, it is determined that on 4/9/21, Child #1 was left unsupervised in the bathroom outside classroom 4 and that Staff #1 was found sleeping while supervising the children.

(continued on LIC9099 page 2)

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Renesha Pack	TELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Adrian L Mangina	TELEPHONE: (619) 767-2209
LICENSING EVALUATOR SIGNATURE:	DATE: 06/04/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2021

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 51-CC-20210421134606

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: 06/04/2021

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

(LIC9099 Page 2)

The allegations are valid because the preponderance of the evidence has been met, therefore, the above allegation is found to be SUBSTANTIATED. Pursuant to Title 22 of the California Code of Regulations, (Title 22, Division 12, Chapter 1, Section 101229(a)(1) Responsibility for Providing Care and Supervision a Type A deficiency was cited on the attached LIC 9099D.

An exit interview was conducted with the Director. A copy of this report (LIC9099), Notice of Site Visit (LIC9213) and Appeal Rights (LIC9058) were provided. Signature at the bottom of this report confirms receipt. Upon receipt of this report, licensee shall post and provide copies of this licensing report to parents /guardians of children in care at the facility and to parent/guardians of children newly enrolled at the facility during the next 12 months. Licensee to provide Acknowledgement of Receipt of Licensing Reports (LIC 9224) for each child in care and have each parent sign the form that they have received a copy of the report LIC 809 and LIC 809D. THIS REPORT MUST BE FILED IN FACILITY FILE AND MADE AVAILABLE FOR PUBLIC REVIEW FOR 3 YEARS. LPA observed posting. Licensee is advised it must remain posted for 30 days. An exit interview was conducted, A copy of this report, LIC9224, and Appeal Rights (1/16) were discussed and provided.

SUPERVISOR'S NAME: Renesha Pack	TELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Adrian L Mangina	TELEPHONE: (619) 767-2209
LICENSING EVALUATOR SIGNATURE:	DATE: 06/04/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2021

LIC9099 (FAS) - (06/04)

Page: 3 of 3

Control Number 51-CC-20210421134606

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: 06/04/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 06/07/2021 Section Cited CCR 101229(a)(1)	1 2 3 4 5 6 7	101229(a)(1) Responsibility for Providing Care and Supervision: No child(ren) shall be left without the supervision of a teacher at any time... supervision shall include visual observation. This requirement was not met as evidenced by:	1 2 3 4 5 6 7	Director conducted a staff training on adequate supervision and nap time protocols on 5/28/21. Director will provide a copy of the staff meeting sign in sheet and agenda to LPA no later than 6/7/21.
	8 9 10 11 12 13 14	On 4/9/21 Child #1 was left in the bathroom alone and covered in excrement with no teacher present. On the same day, Staff #1 was photographed with eyes closed while that staff was alone supervisng the children. This poses an immediate 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 Pack	TELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Adrian L Mangina	TELEPHONE: (619) 767-2209
LICENSING EVALUATOR SIGNATURE:	DATE: 06/04/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2021

LIC9099 (FAS) - (06/04)

Page: 2 of 3