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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 372006509
Report Date: 12/21/2021
Date Signed: 12/21/2021 11:36:16 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
12/14/2021 and conducted by Evaluator Joelle Redding
PUBLIC
COMPLAINT CONTROL NUMBER: 51-CC-20211214160501
FACILITY NAME:BETHLEHEM COMMUNITY EARLY CHILDHOOD CENTERFACILITY NUMBER:
372006509
ADMINISTRATOR:DEBI C. & GAIL W.FACILITY TYPE:
850
ADDRESS:925 BALOUR DRIVETELEPHONE:
(760) 753-4780
CITY:ENCINITASSTATE: CAZIP CODE:
92024
CAPACITY:110CENSUS: 50DATE:
12/21/2021
UNANNOUNCEDTIME BEGAN:
10:20 AM
MET WITH:Director Part Time Program Kelly PerezTIME COMPLETED:
11:40 AM
ALLEGATION(S):
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Child was not attended to properly after having a potty accident
INVESTIGATION FINDINGS:
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On 12/21/21 @ 10:20 a.m., Licensing Program Analyst, Joelle Redding, made an unannounced visit to investigate the above-referenced allegation.

During this visit, LPA interviewed Part Time Program Director Kelly Perez and Staff #1. Based on the information obtained, Staff #1 did not follow school policy with regard to attending to Child #1's potty accident and contacting parent to come assist. All staff should be familiar with and adhere to school policy. The allegation is Substantiated and a Type B deficiency, under Title 22 regulation, will be cited on the accompanying LIC 9099D.

Notice of Site Visit was given and will remain posted for 30 days.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Renesha PackTELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Joelle ReddingTELEPHONE: (619) 767-2222
LICENSING EVALUATOR SIGNATURE:

DATE: 12/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2021
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 2
Control Number 51-CC-20211214160501
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: BETHLEHEM COMMUNITY EARLY CHILDHOOD CENTER
FACILITY NUMBER: 372006509
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/21/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/14/2022
Section Cited
CCR
101216(a)
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Personnel Requirements. Child care center personnel shall be competent to provide the services necessary to meet the individual needs of children in care and shall at all times be employed in numbers sufficient to meet those needs. This requirement has not been met as evidenced by:
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Director Kelly Perez states that Staff #1 was adderssed the following day (12/14) when the Director spoke with the child's mother. The remainder of the staff were addressed regarding this issue on 12/17, reviewing the policies that everyone had signed upon hire and letting them know that amendments will be made to the handbook. The amendments
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Based on interview with Director and staff and review of the Staff Handbook. Staff #1 contacted parent for assistance with Child #1's potty accident against school policy/staff handbook. Not knowing or not following school policy is a potential risk to the health and safety of children in care.
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will be provided to all staff for signature. Copies of the signed amendments will be provided to Licensing for correction by 1/14/21 as the school will be closed for the holiday break from 12/23/21 thru 1/9/22.
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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.
SUPERVISOR'S NAME: Renesha PackTELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Joelle ReddingTELEPHONE: (619) 767-2222
LICENSING EVALUATOR SIGNATURE:

DATE: 12/21/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 2