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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 300603522
Report Date: 01/23/2023
Date Signed: 01/24/2023 11:50:05 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/27/2022 and conducted by Evaluator Stella Gutierrez
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20221027094134
FACILITY NAME:GRACE HARBOR CHURCH AND SCHOOLFACILITY NUMBER:
300603522
ADMINISTRATOR:REBEKAH BAYFACILITY TYPE:
850
ADDRESS:12881 NEWPORT AVENUETELEPHONE:
(714) 544-4431
CITY:TUSTINSTATE: CAZIP CODE:
92780
CAPACITY:78CENSUS: 43DATE:
01/23/2023
UNANNOUNCEDTIME BEGAN:
10:01 AM
MET WITH:Rebekah Bay, director TIME COMPLETED:
01:30 PM
ALLEGATION(S):
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Reprting requirements- Staff did not report injuries to child's auhtorized representative
Personal Rights- Staff leave daycare child soiled in feces
INVESTIGATION FINDINGS:
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This report ws amended on 01/24/2023.
On 01/23/2023 Licensing Program Analyst (LPA), Stella Gutierrez made an unannounced visit to the facility for the purpose of delivering findings of complaint received on 10/27/2022. LPA was met by Rebekah Bay who was explained the reason for today’s visit. Census taken today, LPA observed 07 preschool staff and 43 preschool children in care.
A review of the Facility Personnel Report Summary conducted on 01/23/2023 indicates all facility staff or other individuals who required caregiver background checks have received criminal record and child abuse index clearances or exemptions.

A complaint was received on 10/27/2022 alleging that the staff did not report injuries to the child’s authorized representative and that the staff leave daycare child soiled in feces.

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Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Stella Gutierrez
LICENSING EVALUATOR SIGNATURE:

DATE: 01/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2023
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 5
Control Number 06-CC-20221027094134
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: GRACE HARBOR CHURCH AND SCHOOL
FACILITY NUMBER: 300603522
VISIT DATE: 01/23/2023
NARRATIVE
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This page was amended on 01/24/2023
On 10/27/2022 the reporting party stated that their child came home from the facility on 10/26/2022 with injuries that were not reported to the reporting party and that the facility staff do not clean the children properly when changing their diaper. The reporting party also stated that almost every day the reporting party picks the child up from the facility that the child has a poopy diaper. On 10/28/2022 LPA, Gutierrez contacted the reporting party to obtain more information regarding the alleged allegations. The reporting party stated that on 10/26/2022 their child came home with and injury on the elbow and 2 on the child’s face near the right eye. The reporting party stated that there was another injury prior to this, maybe a couple of months ago and at that time nobody at the facility knew what happened. The Reporting Party stated that the director was contacted asking to be provided an explanation of the injuries from 10/26/2022 and the response was that it would be investigated. The reporting party also stated that the facility does not change the children timely or if they do the children are not cleaned properly due to no changing table in the classroom resulting in a rash. The reporting party also stated that when coming to pick up their child they observed a diaper instead of the pull ups that were provided for the child and reporting party would have to go inside and change the poopy diaper on the floor on the carpet. On 01/03/2022 a follow was provided by the reporting party that the facility director replied on 11/04/2022 to the explanation request submitted on 10/26/2022. The facility director stated that the staff could not provide an explanation on how and when the incident occurred, but the director did advise the reporting party the staff was talked to ensure better supervision and to report any incidents the child’s authorized representatives.

On 11/03/2022. LPA Gutierrez made an unannounced inspection to the facility regarding the alleged allegation of reporting requirements that the staff did not report injuries to child's authorized representative and personal rights, staff leave daycare child soiled in feces.

During the complaint investigation visit conducted on 11/03/2022, LPA interviewed 7 staff (Staff #1- Staff #7), obtained a copy of the personnel report (LIC 500) and the children’s roster (LIC 9040).

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SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Stella Gutierrez
LICENSING EVALUATOR SIGNATURE:

DATE: 01/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 06-CC-20221027094134
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: GRACE HARBOR CHURCH AND SCHOOL
FACILITY NUMBER: 300603522
VISIT DATE: 01/23/2023
NARRATIVE
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This page was amended on 01/24/2023.
On 11/03/2022 Staff #1 (S1) stated that the facility staff lay the children on any available cot or on the floor inside the restroom with nothing underneath. On 11/03 2022 LPA observed a changing table inside the restroom during the tour. On 11/03/2022 Staff #2(S2) Stated that they change diaper with feces while child is standing up. On 11/03/2022 Staff #3 (S3) stated that the teachers are to create their own reports to the parents on the ProCare and that they do change the children with feces standing up. On 11/03/2022 Staff #4 (S4) also stated that if an injury incident occurs that the teacher reports the incident to the parents on ProCare. S4 stated that they do not change any diapers at the facility. On 11/03/2022 Staff #5 (S5) stated that the children are standing up while their diaper with feces is being changed by staff at the facility.

On 11/03/2022 the director stated that the staff report the incidents to the parents. LPA asked the director how does she ensure that the reporting happens? Directors response was, “Well it’s what they are told to do.”

On 12/16/2022 – 12/28/2022 LPA contacted 11 parents of the children enrolled in the preschool program. On 12/19/2022 Parent #3 (P3) stated that their child has come home with 2 injuries that were not reported to them and that their child comes home not cleaned properly when having a diaper with feces. P3 stated that they would have to come inside the facility to change their child sometimes at pick up. On 12/23/2022 Parent #9 (P9) stated that their child has come home with 2 injuries that were not explained on a written report and that their child comes home with diaper rashes regularly. On 12/28/2022 Parent #10 (P10) stated that their child was getting hit by another child at the facility and there was a lot of injuries to their child. P10 stated that their child would come home stating that another child kept throwing things at them. P10 stated that they provided pull ups for their child and the staff would forget to put the pull ups on during nap time which resulted in a child having to change clothing after an accident during nap time. On 12/19/2022 Parent #1, #2, #4, #6 and #7 had no disclosers about the alleged allegations. LPA made multiple attempts to contacted Parent #5 and #8, parents were not responsive to voicemail's left.





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SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Stella Gutierrez
LICENSING EVALUATOR SIGNATURE:

DATE: 01/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 06-CC-20221027094134
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: GRACE HARBOR CHURCH AND SCHOOL
FACILITY NUMBER: 300603522
VISIT DATE: 01/23/2023
NARRATIVE
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This page was amended on 01/24/2023

Based on statements and information received the allegations of reporting requirements, that the staff did not report injuries to child's authorized representative and personal rights- Staff leave daycare child soiled in feces is deemed substantiated. A substantiated finding means that the complaint is substantiated, and the allegations are valid because the preponderance of the evidence standards have been met. The facility staff are not reporting injuries to the authorized representative and the children are not being accommodated with the personal rights of being cleaned properly after a diaper change. It was also observed and stated by the Reporting party that the The following were revealed and are being cited in accordance with California Code of Regulations, Title 22, Division 12, Chapter 1, Section 06 101212 (f) 101223 (a) (2), 2 Type b deficiencies are being cited on the attached LIC 809D.

Exit interview conducted and report was reviewed with the director, Rebekah Bay. Appeal Rights and deficiencies were discussed. The facility representative was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days.



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.

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SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Stella Gutierrez
LICENSING EVALUATOR SIGNATURE:

DATE: 01/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2023
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 06-CC-20221027094134
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: GRACE HARBOR CHURCH AND SCHOOL
FACILITY NUMBER: 300603522
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/23/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/01/2023
Section Cited
CCR
101212(f)
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f) The items specified in (d)(1)(A) through (H) above shall also be reported to the child's authorized representative.

This requirement was not met as evidence by statements received.
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The director agrees that she will move forward and provide the authorized representatives a verbal and written report of any incidents involving their children at the facility. The director will send out an email to all parents at the facility of the importance of this requirement ensuring the effective communication will be followed through to meet this regulation.
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The facility director did not endure that teh authorized representative were communicated of the incidents that invovled their children at teh facility.
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The director will forward this communication to all representatives of the facility by the specified date on 02/01/2023 via email to stella.gutierrez@dss.ca.gov
Type B
01/30/2023
Section Cited
CCR
101223(a)(2)
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101223 Personal Rights
(a) The licensee shall ensure that each child is accorded the following personal rights:
(2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs.
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This page was amended on 01/24/2023.
The director is meeting with the TSP Analyst, Susun Du today, 01/23/2023 in the PM hours to develop a plan and seek further support from their local licensing agency. A written declaration was provided by the director today to start the process of implementing a plan of action to ensure this personal rights of this children enrolled at the facility.
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This requirement was not met as evidence by statements from several staff and parents. The chidlren were not being clearend properly and left in feces that resulted in rashes. This is a health risk that violates the personal rights of the children in care.
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The director will provided the LPA with this plan of action to be taken by 01/30/2023 via email to stella.gutierrez@dss.ca.gov and the completed action thereafter when available . This is a repeat violation and there will be no civil penalty assessed to the repeat being issused the same day.
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: Patricia Magana
LICENSING EVALUATOR NAME: Stella Gutierrez
LICENSING EVALUATOR SIGNATURE:

DATE: 01/24/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2023
LIC9099 (FAS) - (06/04)
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