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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198018207
Report Date: 10/03/2024
Date Signed: 10/07/2024 08:26:05 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 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
08/13/2024 and conducted by Evaluator Mary Silva
PUBLIC
COMPLAINT CONTROL NUMBER: 33-CC-20240813101725
FACILITY NAME:GRACE LUTHERAN CHURCH INFANT CARE CENTERFACILITY NUMBER:
198018207
ADMINISTRATOR:CHRISTY ARREGUINFACILITY TYPE:
830
ADDRESS:17880 E. COVINA BLVDTELEPHONE:
(626) 967-5855
CITY:COVINASTATE: CAZIP CODE:
91722
CAPACITY:16CENSUS: 2DATE:
10/03/2024
UNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Facility Representative Cerise WillsTIME COMPLETED:
03:45 PM
ALLEGATION(S):
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Facility director does not meet infant care qualifications
INVESTIGATION FINDINGS:
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On 10/03/24 Licensing Program Analyst (LPA) Mary Silva conducted a subsequent complaint inspection to conclude the investigation regarding the above complaint allegation. The purpose of the inspection was explained. LPA met with Facility Representative Cerise Wills. LPA was guided on a tour of the facility. There was a total of 2 infants present and 1 staff.

Complainant alleged Facility Director does not meet infant care qualifications.

During the course if this investigation, Licensing staff conducted interviews with two facility staff, facility clergy, parents of children enrolled, reviewed qualifications for staff #1, obtained copies of facility roster, personnel report, designation of responsibility and other documents pertaining to the investigation.
Per record review and interviews conducted, Staff #1 was designated as an infant director due to an emergency that warrant an immediate facility director.
_________________________Page 1_________________________________
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Mary Silva
LICENSING EVALUATOR SIGNATURE:

DATE: 10/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2024
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 33-CC-20240813101725
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: GRACE LUTHERAN CHURCH INFANT CARE CENTER
FACILITY NUMBER: 198018207
VISIT DATE: 10/03/2024
NARRATIVE
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Effective 06/04/24 a letter was issued to families to inform of this occurrence.
Based on the information provided and disclosures made during the department investigation it was determined staff #1 does not meet all the qualifications for infant director. The preponderance of evidence and the standard has been met; therefore, the above allegations are found to be substantiated. California Code of Regulations (Title 22 Division & Chapter), are being cited on the attached deficiencies page LIC 9099-D.
A notice of site visit was given and must remain posted for 30 days. Appeal Rights provided.
Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
Appeal rights were provided.

Exit interview conducted and report was reviewed with the facility representative Cerise Wills.

________________________Page 2________________________________
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Mary Silva
LICENSING EVALUATOR SIGNATURE:

DATE: 10/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 33-CC-20240813101725
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: GRACE LUTHERAN CHURCH INFANT CARE CENTER
FACILITY NUMBER: 198018207
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/03/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/24/2024
Section Cited
CCR
101415(c)
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At least three of the semester or equivalent quarter units required in Sections 101215.1(h)(1)(B), (h)(2) and (h)(3) shall be related to the care of infants… This requirement was not met evidenced by:
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Per facility representative will provide a letter requesting an exception to allow staff #1 to act as Infant Director in the interim of completing infant course by December 2024.
In addition facility will submit all required documents and forms to CCL office to notify of the change in director for the infant program.
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Based on the information provided and disclosures made during the department investigation it was determined staff #1 does not meet all the qualifications for infant director. Staff #1 has not completed the required three semester units related to infant care, Preventative Health & Safety training, Application orientation certificate & Operation/Record Keeping certificate
which poses a potential risk of the health, safety, and personal rights of children in care.
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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: Christina Gabelman
LICENSING EVALUATOR NAME: Mary Silva
LICENSING EVALUATOR SIGNATURE:

DATE: 10/03/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2024
LIC9099 (FAS) - (06/04)
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