372000312-1-10-2022-51-CC-RPAK-CATVC7-20220119151841

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 372000312
Report Date: 01/10/2022
Date Signed: 01/10/2022 02:12:10 PM

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
10/28/2021 and conducted by Evaluator Adrian L Mangina

PUBLIC

COMPLAINT CONTROL NUMBER: 51-CC-20211028135607

FACILITY NAME:	LA JOLLA UNITED METHODIST CHURCH NURSERY SCHOOL		FACILITY NUMBER:	372000312
ADMINISTRATOR:	BRIDGET MUSANTE		FACILITY TYPE:	850
ADDRESS:	6063 LA JOLLA BOULEVARD		TELEPHONE:	(858) 454-1418
CITY:	LA JOLLA	STATE: CA	ZIP CODE:	92037
CAPACITY:	90	CENSUS: 31	DATE:	01/10/2022
		UNANNOUNCED	TIME BEGAN:	01:45 PM
MET WITH:	Erin Wyer		TIME COMPLETED:	02:15 PM

ALLEGATION(S):

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Staff are not following Covid-19 mandates

INVESTIGATION FINDINGS:

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On 1/10/22 at 1:45 PM Licensing Program Analysts (LPAs) Adrian Mangina and Daniel Pena made an unannounced complaint visit for the complaint received on 10/28/21 for the purpose of delivering findings on the above referenced allegation.

Based on the information obtained during interviews, observations, and documentation reviewed, LPAs were unable to corroborate the allegation that staff are not following Covid-19 mandates. 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 allegation is unsubstantiated

Exit interview conducted and report was reviewed with facility representative Erin Wyer. 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.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Renesha Pack	TELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Adrian L Mangina	TELEPHONE: (619) 629-6197
LICENSING EVALUATOR SIGNATURE:	DATE: 01/10/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2022

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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