376700698-10-6-2021-10-CC-SHUK-C7TW33-20211015165516

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 376700698
Report Date: 10/06/2021
Date Signed: 10/06/2021 10:39:39 AM

Unsubstantiated

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
10/01/2021 and conducted by Evaluator Jeanette Sanchez

PUBLIC

COMPLAINT CONTROL NUMBER: 10-CC-20211001154814

FACILITY NAME:	NORTH COAST CHURCH PRESCHOOL		FACILITY NUMBER:	376700698
ADMINISTRATOR:	MARCIA BOECHE		FACILITY TYPE:	850
ADDRESS:	2405 NORTH SANTA FE AVENUE		TELEPHONE:	(760) 330-9200
CITY:	VISTA	STATE: CA	ZIP CODE:	92084
CAPACITY:	165	CENSUS: 79	DATE:	10/06/2021
		ANNOUNCED	TIME BEGAN:	09:04 AM
MET WITH:	Marcia Boeche		TIME COMPLETED:	10:45 AM

ALLEGATION(S):

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Children are not wearing masks in facility.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Jeanette Sanchez made an initial 10-Day unannounced complaint investigation visit to address the above allegation. LPA met with Director Marcia Boeche, for an interview and to discuss complaint allegation.

During this visit, LPA took census and toured the facility. Director was interviewed on this date. During the visit, adults, including staff and visitors, and children were all wearing masks. Masks were observed at the entrance and classrooms. Two observations: 9:10am and 9:38am.

Room 5: 4 children (all 4 wearing masks)
Room 6: 11 children (all 11 wearing masks)
Room 8: 7 children (all 7 wearing masks)
Room 9: 10 children (all 10 wearing masks)
Other children and teachers were outside

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Stephanie Hudak
LICENSING EVALUATOR NAME: Jeanette Sanchez
LICENSING EVALUATOR SIGNATURE:	DATE: 10/06/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/06/2021

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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Control Number 10-CC-20211001154814

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: NORTH COAST CHURCH PRESCHOOL	FACILITY NUMBER: 376700698
	VISIT DATE: 10/06/2021

NARRATIVE

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Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.

An exit interview was conducted. The appeal rights were discussed and provided along with a copy of this report to Director Marcia Boeche on this date. A Notice of Site Visit (LIC 9213) was posted. The Notice of Site Visit must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

SUPERVISORS NAME: Stephanie Hudak
LICENSING EVALUATOR NAME: Jeanette Sanchez
LICENSING EVALUATOR SIGNATURE:	DATE: 10/06/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/06/2021

LIC9099 (FAS) - (06/04)

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