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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 330911138
Report Date: 07/16/2026
Date Signed: 07/16/2026 02:26:15 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/30/2026 and conducted by Evaluator Giselle Carbullido
PUBLIC
COMPLAINT CONTROL NUMBER: 09-CC-20260630151248
FACILITY NAME:IMMANUEL LUTHERAN PRESCHOOLFACILITY NUMBER:
330911138
ADMINISTRATOR:ANGIE KNAPPFACILITY TYPE:
850
ADDRESS:5455 ALESSANDRO BLVD.TELEPHONE:
(951) 682-4211
CITY:RIVERSIDESTATE: CAZIP CODE:
92506
CAPACITY:87CENSUS: 29DATE:
07/16/2026
UNANNOUNCEDTIME BEGAN:
11:20 AM
MET WITH:Angie Knapp and Jean KempeTIME COMPLETED:
02:30 PM
ALLEGATION(S):
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Facility playground is not kept clean.
INVESTIGATION FINDINGS:
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On the date and time listed above, Licensing Program Analyst (LPA) Giselle Carbullido conducted a subsequent complaint investigation to deliver final findings. An initial visit was conducted on 07/01/26 at which time LPA conducted interviews and reviewed records. LPA met with Director, Angie Knapp conducted additional interviews; toured the facility and took a census.
During the investigation, LPA reviewed records and interviewed pertinent parties, including facility staff.

It was alleged facility playground is not kept clean; specifically, the toddler playground toys are dirty and the toddler sandbox has spiders/ webs. Staff interviews stated play equipment can get dirty due to weather and webs are cleaned up if observed or reported. Staff reported that the playground areas are tidy; the toddler sandbox is not in use due to spiders and wet sand from the sprinkler; and that monthly pest control is used for pests. LPA toured all playgrounds and observed dust /dirt and light webs on toys sturcutres. LPA observed toddler sandbox is covered with wooden doors and accessible to children in care on the far
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Giselle Carbullido
LICENSING EVALUATOR SIGNATURE:

DATE: 07/16/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2026
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 6
Control Number 09-CC-20260630151248
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: IMMANUEL LUTHERAN PRESCHOOL
FACILITY NUMBER: 330911138
VISIT DATE: 07/16/2026
NARRATIVE
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 side of toddler playground. LPA observed spider webs/egg sac, a dead spider and wet sand underneath the doors.
Based on information gathered from staff interviews and records, the preponderance of evidence standard has been met, therefore, the above allegations are found to be SUBSTANTIATED. Per California Code of Regulations, Title 22, Division 12, CCR 101238.2(d)(1) is cited on the attached LIC9099D.
Appeal rights issued and discussed with facility representative and their signature on this form acknowledges receipt of these rights.
An exit interview was conducted and a copy of this report and notice of site visit were provided to facility representative, Angie Knapp. A copy of this report must be made available to the public upon request for three years
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Giselle Carbullido
LICENSING EVALUATOR SIGNATURE:

DATE: 07/16/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 6
Control Number 09-CC-20260630151248
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: IMMANUEL LUTHERAN PRESCHOOL
FACILITY NUMBER: 330911138
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/16/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/20/2026
Section Cited
CCR
101238.2(d)(1)
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101238.2(d)(1) Outdoor Activity Space: (1) In a safe condition for the activities planned. This requirement is not met as evidenced by:
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Facility will submit a written plan of action to ensure the outdoor activity space is maintained in a safe condition for outdoor activity and submit proof (pictures) of toy structures, toys and sand boxes are cleaned.
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Based on LPA observation of dirt/debris, light webs on toy structures; spider sacs/webs and wet sand in the sandbox. The facility did not ensure the playground is maintained in a safe condition for activities planned which poses a potential health and safety risk to 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.
SUPERVISOR'S NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Giselle Carbullido
LICENSING EVALUATOR SIGNATURE:

DATE: 07/16/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2026
LIC9099 (FAS) - (06/04)
Page: 6 of 6