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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 010205821
Report Date: 01/03/2022
Date Signed: 01/07/2022 11:05:52 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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/24/2021 and conducted by Evaluator Jaylena Miller
PUBLIC
COMPLAINT CONTROL NUMBER: 52-CC-20211224082538
FACILITY NAME:VALLEY CHRISTIAN PRESCHOOLFACILITY NUMBER:
010205821
ADMINISTRATOR:JARIN, RINAFACILITY TYPE:
850
ADDRESS:7500 INSPIRATION DRIVETELEPHONE:
(925) 560-6235
CITY:DUBLINSTATE: CAZIP CODE:
94568
CAPACITY:132CENSUS: 42DATE:
01/03/2022
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Rina JarinTIME COMPLETED:
11:30 AM
ALLEGATION(S):
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9
Staff not wearing mask
INVESTIGATION FINDINGS:
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13
On 1/7/2022 Licensing Program Analysts (LPAs) Jaylena Miller and Christina Uribe conducted an unannounced complaint investigation regarding the above allegation and the purpose of the visit was explained to director, Rina Jarin.
During the investigation LPAs conducted a physical plant inspection of the facility and took a headcount of all staff and children present.
On 12/17/2021 the facility, Valley Christian Preschool, did not ensure the personal rights of persons in care, to safe and healthful accommodations and engaged in conduct inimical to the health, welfare, and safety of persons in care, in that the facility staff did not wear face coverings while in the facility caring for children as required by the California Department of Public health Guidance on the use of Face Coverings issued June 18, 2020 and updated December 15, 2021, and an individual mask exception did not apply.
This agency has investigated the complaint alleging the facility staff are not wearing mask. Based on LPAs observation, interviews which were conducted and record reviews, the preponderance of evidence standard has been met, therefore the above allegation is to be SUBSTSNTIATED. As a result, and per California Code of Regulations, Title 22, Division 12, Chapter 1 Section 101223(a)(2) is being cited. Please see LIC 9099-D for deficiency.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jaylena Miller
LICENSING EVALUATOR SIGNATURE:

DATE: 01/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/03/2022
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 52-CC-20211224082538
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: VALLEY CHRISTIAN PRESCHOOL
FACILITY NUMBER: 010205821
VISIT DATE: 01/03/2022
NARRATIVE
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The director must post this report for thirty days. The director must give each parent of the children in care and future parents of newly enrolled children, for the next one year following today’s date, a copy of this report. Parents are to sign an LIC 9224- Acknowledgment of Receipt of Licensing reports and this form shall be placed in each child’s file. Failure to post report and or provide a copy of this report to parent’s/authorized guardians can result in additional monetary assessments to the facility. Notice of site visit given and must be posted for 30 days.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jaylena Miller
LICENSING EVALUATOR SIGNATURE:

DATE: 01/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/07/2022
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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/24/2021 and conducted by Evaluator Jaylena Miller
PUBLIC
COMPLAINT CONTROL NUMBER: 52-CC-20211224082538

FACILITY NAME:VALLEY CHRISTIAN PRESCHOOLFACILITY NUMBER:
010205821
ADMINISTRATOR:JARIN, RINAFACILITY TYPE:
850
ADDRESS:7500 INSPIRATION DRIVETELEPHONE:
(925) 560-6235
CITY:DUBLINSTATE: CAZIP CODE:
94568
CAPACITY:132CENSUS: 42DATE:
01/03/2022
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Rina JarinTIME COMPLETED:
11:30 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Children not wearing mask while in care
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 1/7/2022 Licensing Program Analysts (LPAs) Jaylena Miller and Christina Uribe conducted an unannounced complaint investigation regarding the above allegation and the purpose of the visit was explained to director, Rina Jarin.
During the investigation LPAs conducted a physical plant inspection of the facility and took a headcount of all staff and children present.
On 12/17/2021 and 01/7/2022 the facility, Valley Christian Preschool, did not ensure the personal rights of persons in care, to safe and healthful accommodations and engaged in conduct inimical to the health, welfare, and safety of persons in care, in that the facility did not ensure all children were wearing face coverings while indoors at the facility while in care as required by the California Department of Public health Guidance on the use of Face Coverings issued June 18, 2020 and updated December 15, 2021, and an individual mask exception did not apply.
This agency has investigated the complaint alleging the facility staff are not ensuring children are wearing masks while indoors during care. Based on LPAs observation, interviews which were conducted and record reviews, the preponderance of evidence standard has been met, therefore the above allegation is to be SUBSTSNTIATED. As a result, and per California Code of Regulations, Title 22, Division 12, Chapter 1 Section 101223(a)(2) is being cited.
Please see LIC 9099-D for deficiency.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jaylena Miller
LICENSING EVALUATOR SIGNATURE:

DATE: 01/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/07/2022
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 52-CC-20211224082538
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: VALLEY CHRISTIAN PRESCHOOL
FACILITY NUMBER: 010205821
VISIT DATE: 01/03/2022
NARRATIVE
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The director must post this report for thirty days. The director must give each parent of the children in care and future parents of newly enrolled children, for the next one year following today’s date, a copy of this report. Parents are to sign an LIC 9224- Acknowledgment of Receipt of Licensing reports and this form shall be placed in each child’s file. Failure to post report and or provide a copy of this report to parent’s/authorized guardians can result in additional monetary assessments to the facility. Notice of site visit given and must be posted for 30 days.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jaylena Miller
LICENSING EVALUATOR SIGNATURE:

DATE: 01/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/07/2022
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 52-CC-20211224082538
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: VALLEY CHRISTIAN PRESCHOOL
FACILITY NUMBER: 010205821
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/03/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type B
01/07/2022
Section Cited
CCR
101223(a)(2)
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The licensee shall ensure that each child is accorded the following personal rights: (2) To be accorded safe, healthful and comfortable accommodations... This was not met as evidence by:
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Director will notify all staff and parents that mask are required while indoors immediately. Director will post Guidance for the Use of Masks by the CA Dept. of Public Health for all parents and staff by 1/10/2022.
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Based on observation, interviews and record review, the facility did not ensure staff and children wore mask indoors during the mask mandate which poses an immediate risk to the health and safety to children in care.
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Failure to correct will result in a $100 per day civil penalty until corrected. Repeat violations are $250 per violation and $100 per day until corrected.
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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.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jaylena Miller
LICENSING EVALUATOR SIGNATURE:

DATE: 01/07/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/07/2022
LIC9099 (FAS) - (06/04)
Page: 5 of 5