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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 360900326
Report Date: 08/25/2021
Date Signed: 08/25/2021 11:12:15 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 ST., SUITE 700
RIVERSIDE, CA 92501
This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/23/2021 and conducted by Evaluator Giselle Carbullido
PUBLIC
COMPLAINT CONTROL NUMBER: 09-CC-20210823103255
FACILITY NAME:FIRST PRESBYTERIAN CHURCH PRESCHOOLFACILITY NUMBER:
360900326
ADMINISTRATOR:WREN, MISTYFACILITY TYPE:
850
ADDRESS:869 N. EUCLID AVENUETELEPHONE:
(909) 982-8616
CITY:UPLANDSTATE: CAZIP CODE:
91786
CAPACITY:126CENSUS: 0DATE:
08/25/2021
UNANNOUNCEDTIME BEGAN:
08:50 AM
MET WITH:Misty Wren, DirectorTIME COMPLETED:
11:30 AM
ALLEGATION(S):
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Staff and day care children are not wearing masks.
INVESTIGATION FINDINGS:
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On 08/25/2021 at 8:50AM Licensing Program Analyst (LPA) Giselle Carbullido conducted an unannounced visit regarding a complaint received concerning the above allegation. LPA was given access to the facility by Director Misty Wren. LPA discussed purpose of visit, took census and toured the facility. LPA met with Ms. Wren to further discuss the complaint allegation(s) and deliver findings.

It was alleged the facility is not following Covid-19 guidelines for masks by staff and children.
At 9 am, LPA toured the facility and observed staff wearing masks and no children present due to school break. LPA conducted interviews with staff. Interviews revealed staff are required to wear masks at all times and preschool children are not required and/or do not have to wear masks indoors unless they want to or a parent request is made.

Based on evidence gathered and staff intervews the complaint allegation is substantiated, meaning the allegation is valid and the preponderance of the evidence standard has been met.

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Giselle Carbullido
LICENSING EVALUATOR SIGNATURE:

DATE: 08/25/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2021
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 2
Control Number 09-CC-20210823103255
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 ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: FIRST PRESBYTERIAN CHURCH PRESCHOOL
FACILITY NUMBER: 360900326
VISIT DATE: 08/25/2021
NARRATIVE
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LPA provided technical assistance to Licensee by reviewing and providing a copy of the current guidelines (as outlined by the California Department of Public Health) for family child care as follows:

1) California Department of Public Health
a. Guidance for Child Care Providers and Programs
Released on June 29, 2021
b. https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/Child-Care-Guidance.aspx#

2) California Department of Public Health


a. Guidance for Face Coverings
Released on July 28, 2021
b. https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/guidance-for-face-coverings.aspx

3) https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/Face-Coverings-QA.aspx



An exit interview was conducted, and appeal rights discussed. LPA provided Licensee with a copy of this report, appeal rights and notice of site visit. 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: 08/25/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 2