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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 191503710
Report Date: 02/12/2025
Date Signed: 02/12/2025 11:48:24 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/03/2024 and conducted by Evaluator Kruz Long
PUBLIC
COMPLAINT CONTROL NUMBER: 33-CC-20241203142755

FACILITY NAME:MT. CALVARY LUTHERAN PRESCHOOL & DAY CARE CENTERFACILITY NUMBER:
191503710
ADMINISTRATOR:GEORGETTE DELGADOFACILITY TYPE:
850
ADDRESS:23300 EAST GOLDEN SPRINGS DR.TELEPHONE:
(909) 861-2740
CITY:DIAMOND BARSTATE: CAZIP CODE:
91765
CAPACITY:67CENSUS: 56DATE:
02/12/2025
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Janet Diaz, Pre-K Teacher/Assistant DirectorTIME COMPLETED:
12:00 PM
ALLEGATION(S):
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Outdoor equipment is unsafe for children in care.
INVESTIGATION FINDINGS:
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On 02/12/2025, Licensing Program Analyst (LPA) Kruz Long conducted an unannounced complaint investigation for the above allegation. A COVID-19 risk assessment was conducted. Upon arrival, LPA met with Janet Diaz, Pre-K Teacher/Assistant Director and explained the purpose of the visit. There are 67 children enrolled. 56 children and 6 Staff members are present in 3 different classrooms during today's visit.

During the course of this investigation, LPA toured the facility with the Assistant Director, interviewed Staff #1(S1) to Staff #4 (S4) in the office and obtained a copies of the children roster and records for Staff #5 (S5) and Staff #6 (S6). LPA also interviewed Parent #1 (P1) to Parent #3 (P3) and Child #1 (C1) to Child #3 (C3).

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Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Kruz Long
LICENSING EVALUATOR SIGNATURE:

DATE: 02/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 6
Control Number 33-CC-20241203142755
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: MT. CALVARY LUTHERAN PRESCHOOL & DAY CARE CENTER
FACILITY NUMBER: 191503710
VISIT DATE: 02/12/2025
NARRATIVE
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Regarding the allegation: Outdoor equipment is unsafe for children in care. RP alleged that a metal gate separating the outdoor play yard and a ledge is unstable. LPA toured the outdoor play yard and observed a metal fence which is located on the preschool side of the facility. LPA tested test the stability of the fence and found it to be unstable and wobbly. LPA deemed the unstable fence to be a health and safety risk for the children and advised the facility to immediately block off the fence and conduct repairs.

Based on LPA’s observation, the preponderance of the evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 12 & Chapter 1, Article 07, 101238.2(g)(1) is being cited on the attached LIC9099D.

An exit Interview was conducted, a copy of this report and appeal rights along with Notice of Site visit was provided to Janet Diaz. Notice of Site visit must be posted for 30 days.

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Kruz Long
LICENSING EVALUATOR SIGNATURE:

DATE: 02/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 6
Control Number 33-CC-20241203142755
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: MT. CALVARY LUTHERAN PRESCHOOL & DAY CARE CENTER
FACILITY NUMBER: 191503710
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/12/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/26/2025
Section Cited
CCR
101238.2(g)(1)
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101238.2 Outdoor Activity Space
(g) The playground shall be enclosed by a fence to protect children and to keep them in the outdoor activity area. The fence shall be at least four feet high. (1) The intent of this requirement is to have a fence that will keep children from leaving the outdoor activity
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LPA advised facility to conduct immediately repairs to the fence during the initial visit. During today's visit, LPA observed the repairs to be complete and no longer presents a health and safely risk to children.
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area unnoticed but will not in and of itself present a hazard.....
This requirement is met as evidenced by: Outdoor play yard fence dividing the play yard and ledge is unstable.
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POC cleared at time of today's visit.
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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.
SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Kruz Long
LICENSING EVALUATOR SIGNATURE:

DATE: 02/12/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2025
LIC9099 (FAS) - (06/04)
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