<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 334813497
Report Date: 06/05/2024
Date Signed: 06/05/2024 10:00:22 AM

Substantiated


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
03/29/2024 and conducted by Evaluator Anastasia Flores
PUBLIC
COMPLAINT CONTROL NUMBER: 10-CC-20240329104334
FACILITY NAME:CORNERSTONE CHRISTIAN PRESCHOOLFACILITY NUMBER:
334813497
ADMINISTRATOR:MARIE MARKHAMFACILITY TYPE:
850
ADDRESS:40333 ACACIA AVENUETELEPHONE:
(951) 929-5007
CITY:HEMETSTATE: CAZIP CODE:
92544
CAPACITY:108CENSUS: DATE:
06/05/2024
UNANNOUNCEDTIME BEGAN:
09:10 AM
MET WITH:Marie Markham TIME COMPLETED:
10:20 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff did not report incident to authorized representative
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On June 04, 2024, at 09:10 AM, Licensing Program Analyst (LPA) Anastasia Flores, met with Director, Marie Markham to deliver the findings on the above stated allegations. On April 5, 2024, at 08:28 AM, LPA Flores conducted a health and safety inspection, no immediate concerns were noted. Copies of confidential records, and photos were obtained. Interviews were conducted with five staff (S1, S2, S3, S4, S5) and three confidential interviews.

On 03/29/24, our agency received allegation that staff did not report incident to authorized representative. Confidential interviews disclosed the parent of C1 was notified verbally by S2, that C1 tapped the nose and reopened a wound during outside play. Other confidential interviews disclosed that facility video footage showed C1 running around for around 15 to 20 minutes after the injury occurred.
Confidential interviews disclosed that staff informed the family of Child #1 (C1) that C1 had tapped the nose during outside play. Other confidential interviews revealed that staff informed family of C1 at pick up time, that C1 tapped and reopened an old wound.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: Anastasia Flores
LICENSING EVALUATOR SIGNATURE:

DATE: 06/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2024
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 5
Control Number 10-CC-20240329104334
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: CORNERSTONE CHRISTIAN PRESCHOOL
FACILITY NUMBER: 334813497
VISIT DATE: 06/05/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Interviews conducted with four out of five staff revealed that there was no ouch report given to the parent of C1 on 3/28/24, stating the dad did not seem to be concerned with the injury and hurriedly walked out. Interview with one out of four staff stated the ouch report was written, however the father of C1 did not want to wait for it. Other confidential interviews disclosed that an incident report was not written prior to A2 arriving to pick up C1. Interview with Director revealed that an ouch report for incident that occurred on 3/28/24 was emailed to parent of C1 on 4/03/24. Confidential interviews disclosed that the director stated staff would be retrained on writing ouch reports due to the incident that occurred on 3/28/24 with C1. Record review revealed that ouch report was emailed to family of C1 on 04/03/24. Record review disclosed the incident report was reported to Community Care Licensing on 04/03/24.

Based on interviews and record review, the preponderance of evidence has been met, and the allegation that staff did not report incident to authorize representative in writing is substantiated. The facility is being cited for Title 22, chapter 12, section; 102416.2 (f) Reporting requirements.

A copy of this report, appeal rights and Notice of Site Visit were provided to Director.

The Notice of Site Visit was posted by the Director prior to LPA leaving the facility and the Director was reminded this notice must be posted for 30 days.
SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: Anastasia Flores
LICENSING EVALUATOR SIGNATURE:

DATE: 06/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 5
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
03/29/2024 and conducted by Evaluator Anastasia Flores
PUBLIC
COMPLAINT CONTROL NUMBER: 10-CC-20240329104334

FACILITY NAME:CORNERSTONE CHRISTIAN PRESCHOOLFACILITY NUMBER:
334813497
ADMINISTRATOR:MARIE MARKHAMFACILITY TYPE:
850
ADDRESS:40333 ACACIA AVENUETELEPHONE:
(951) 929-5007
CITY:HEMETSTATE: CAZIP CODE:
92544
CAPACITY:108CENSUS: DATE:
06/05/2024
UNANNOUNCEDTIME BEGAN:
09:10 AM
MET WITH:Marie Markham TIME COMPLETED:
10:20 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Child(ren) sustained an injury while in care due to lack of supervision
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On June 04, 2024, at 09:10 AM, Licensing Program Analyst (LPA) Anastasia Flores, met with Director, Marie Markham to deliver the findings on the above stated allegations. On April 5, 2024, at 08:28 AM, LPA Flores conducted a health and safety inspection, no immediate concerns were noted. Copies of confidential records, and photos were obtained. Interviews were conducted with five staff (S1, S2, S3, S4, S5) and three confidential interviews.

On 03/29/24, our agency received allegation that children sustained an injury while in care due to lack of supervision. Confidential interviews disclosed that Child #1, #2 (C1, C2) received numerous injuries in the facility due to lack of supervision. Interview with staff, deny facility has been out of ratio at any time. Confidential interviews disclosed that C1 was injured on 3/27/24 at the CC either in the playroom or the playground. Interview with Director denied that C1 was injured at the CC on 3/27/24 and that C1’s parent told staff C1 was hurt in the playroom or playground.
Interview with four, staff revealed the playground was supervised in four different areas with the staff to child ratio being met.

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: Anastasia Flores
LICENSING EVALUATOR SIGNATURE:

DATE: 06/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 10-CC-20240329104334
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: CORNERSTONE CHRISTIAN PRESCHOOL
FACILITY NUMBER: 334813497
VISIT DATE: 06/05/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Based on interviews, the allegation that children sustained injuries while in care due to lack of supervision may have occurred, however is not supported or proven by evidence. Therefore, the allegation is unsubstantiated. A copy of this report, appeal rights and Notice of Site Visit were provided to Director.

The Notice of Site Visit was posted by the Director prior to LPA leaving the facility and the Director was reminded this notice must be posted for 30 days.
SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: Anastasia Flores
LICENSING EVALUATOR SIGNATURE:

DATE: 06/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2024
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 10-CC-20240329104334
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: CORNERSTONE CHRISTIAN PRESCHOOL
FACILITY NUMBER: 334813497
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/05/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/19/2024
Section Cited
CCR
102416.2(f)
1
2
3
4
5
6
7
102416.2 (f) Reporting requirements;As soon as possible but no later than the same business day, the licensee shall notify a child's parent or authorized representative regardless of the injuries or acts that affect that child as specified in Health and Safety Code Section 1597.467(a). This was not met as evidenced by....
1
2
3
4
5
6
7
Director retrained staff on reporting incident reports/ouch reports, facility has created a behavior/incident log for each classrom, the assistant Director/and or Director will review the log daily and write out an unusual incident report the next day if needed.
8
9
10
11
12
13
14
Based on evidence gathered and interviews conducted, the licensee did not notify the parent/guardian of Child #1, in writing within 24 hours of incident that occured. This poses a potential health, safety and personal rights risk to children in care.
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: Pauline Beschorner
LICENSING EVALUATOR NAME: Anastasia Flores
LICENSING EVALUATOR SIGNATURE:

DATE: 06/05/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2024
LIC9099 (FAS) - (06/04)
Page: 5 of 5