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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334845899
Report Date: 04/25/2022
Date Signed: 04/25/2022 01:04:19 PM

Document Has Been Signed on 04/25/2022 01:04 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:GRACE CHRISTIAN PRESCHOOLFACILITY NUMBER:
334845899
ADMINISTRATOR:BROWN, BAILEIGHFACILITY TYPE:
850
ADDRESS:2781 S LINCOLN AVETELEPHONE:
(951) 736-7466
CITY:CORONASTATE: CAZIP CODE:
92882
CAPACITY: 92TOTAL ENROLLED CHILDREN: 92CENSUS: 74DATE:
04/25/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:10 AM
MET WITH: Baileigh BrownTIME COMPLETED:
01:10 PM
NARRATIVE
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Licensing Program Analysts (LPAs) Blanca Ruiz and Karrene Phillips arrived at the facility to conduct a case management inspection in response to the receipt of an unusual incident report (UIR) from the facility. The UIR was received by the licensing agency on 03/09/2022. It documents an incident involving a child who alleged that another child touched their private parts while in the bathroom after taking a nap. At the time of the inspection, LPAs toured the facility, took census, and met with Director, Baileigh Brown. Additional interviews with pertinent parties were conducted to obtain details regarding the reported incident.

During the inspection, LPAs toured the facility, and the area were the alleged incident took place. LPAs observed staff at the facility providing care and supervision; as well as to transition children from one activity to another.

Facility records were reviewed, and staff and children were interviewed. Based on the information gathered, the following violation has been identified:

101229(a)(1) Care and Supervision. No child(ren) shall be left without the supervision, including visual observation, of a teacher at any time except as specified in sections 101216.2(e)(1) and 101230(c)(1). Staff #1 admitted failing to provide adequate supervision for Child N.1 and Child N.2 when both children were in the restroom. Per information obtained during inspection, both children were in the restroom at the same time and one touch another in their private parts accidentally when swinging their arms.

See Lic 809D for cited deficiencies of the California Code of Regulation, Title 22, Div. 12.

An exit interview was conducted, appealed rights discussed, and a copy of this reports was provided to facility Director, Baileigh Brown.

A copy of this report must be made available to the public,at the facility site, for 3 years.

SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Blanca Ruiz-Silva
LICENSING EVALUATOR SIGNATURE: DATE: 04/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/25/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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Document Has Been Signed on 04/25/2022 01:04 PM - It Cannot Be Edited

Citations on this Visit Report are Under Appeal!


Created By: Blanca Ruiz-Silva On 04/25/2022 at 11:19 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: GRACE CHRISTIAN PRESCHOOL
FACILITY NUMBER: 334845899

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/25/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Under Appeal
Type A
04/26/2022
Section Cited
CCR
101229(a)(1)

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101229(a)(1) Care and Supervision. No child(ren) shall be left without the supervision, including visual observation, of a teacher at any time except as specified in sections 101216.2(e)(1) and 101230(c)(1). This requirement was not met as: Staff #1 admitted failing to provide adequate supervision for Child N.1 and Child N.2 when both children were in the restroom.
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Licensee agrees to conduct in service training to obtain training for staff regarding SUPERVISION and to provide CCL with sign in sheet/ agenda of topic and date and time of training by 04/26/22. Licensee agrees to submit a statement upon completion of training on how the center will prevent this from occurring in the future. Please contact CCL by 05/16/22 to provide training date.
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Per information obtained during inspection, both children were in the restroom at the same time and one touch another in their private parts accidentally.
Staff #1 admitted that she did not know how the incident occurred. This is an immediate risk to Health, Safety & Personal Rights to the 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:Aaron Ross
LICENSING EVALUATOR NAME:Blanca Ruiz-Silva
LICENSING EVALUATOR SIGNATURE:
DATE: 04/25/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/25/2022


LIC809 (FAS) - (06/04)
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