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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073405642
Report Date: 02/22/2024
Date Signed: 02/22/2024 04:43:01 PM

Document Has Been Signed on 02/22/2024 04:43 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, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:CORNERSTONE CHRISTIAN PRESCHOOLFACILITY NUMBER:
073405642
ADMINISTRATOR:JEFFUS, DENISEFACILITY TYPE:
850
ADDRESS:2800 SUNSET LANETELEPHONE:
(925) 754-8058
CITY:ANTIOCHSTATE: CAZIP CODE:
94509
CAPACITY: 60TOTAL ENROLLED CHILDREN: 57CENSUS: 50DATE:
02/22/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Terri BrysonTIME COMPLETED:
04:45 PM
NARRATIVE
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On 02/22/2024 at 10:30 AM, Licensing Program Analyst (LPA) Christina Watts conducted an Case Management - Incident Inspection at Cornerstone Christian Preschool. LPA met with Director, Terri Bryson and explained the purpose of today's inspection. During today's inspection, there were 50 preschool aged children with 7 staff in 3 classrooms. Director stated there are 57 preschool aged children. All staff caring and supervising children have Criminal Record Clearance.

LPA is following up on an self reported Unusual Incident Report (UIR). On 02/09/2024 at 11:20 AM, C1 and C2 were playing together when C1 reported to S1 that C2 had hit C1 on the arm and face. S1 stated that they spoke with C1 about using their words instead of their hands when C1 is frustrated. S1 stated both C1 and C2 went back to playing together and S1 continue to clean the classroom. S1 stated that C2 came to S2 and said that C1 bit C2. S1 stated they seen a bite mark on C2 but it did not break skin. S1 stated they brought C1 and C2 to S2 and went back to cleaning and helping transition. S2 stated they talked to both C1 and C2 about the incident. Director stated that S2 came with C1 and C2 and informed Director of the incident. The Director stated that while S3 was in the classroom when the incident occurred, S3 was not aware that the incident had occurred. S2 stated that they did not witness the incident occur as they were cleaning the classroom. LPA informed Director that 100% visual supervision is required in a licensed facility. The facility is in violation of California Code of Regulation, Title 22. LPA Christina Watts informed Director, Terri Bryson that this report dated 02/22/2024 documents a Type B citation. Type B citation(s) are a potential risk(s) to the health, safety, or personal rights of children in care. *SEE LIC 809-D FOR DEFICIENCIES*

Also during today's inspection, Director requested assistance with Director's Qualifications Packet. LPA reviewed the Director's Packet with Director, Terri Bryson. As of 02/22/2024, Director Terri Bryson is Qualified Preschool Director in accordance with California Code of Regulations, Title 22. Exit interview conducted and report was reviewed with the Asst Director, Denise Jeffus. Notice of Site Visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Christina Watts
LICENSING EVALUATOR SIGNATURE: DATE: 02/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/22/2024
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 02/22/2024 04:43 PM - It Cannot Be Edited


Created By: Christina Watts On 02/22/2024 at 02:09 PM
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
, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: CORNERSTONE CHRISTIAN PRESCHOOL
FACILITY NUMBER: 073405642

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/22/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/01/2024
Section Cited
CCR
101229(a)(1)

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101229 Responsibility for Providing Care and Supervision (a) The licensee shall provide care and supervision as necessary to meet the children's needs.(1) No child(ren) shall be left without the supervision of a teacher at any time...Supervision shall include visual observation.
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By 03/01/2024, Director stated they will submit a written statement on how facility will come back into compliance. 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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This requirement has not been met as evidenced by: Based on interviews, the licensee did not comply with the section cited above when staff failed to supervise children including C1 and C2 which poses an potential risk to the health, safety or personal rights of 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:Sherelle Johnson
LICENSING EVALUATOR NAME:Christina Watts
LICENSING EVALUATOR SIGNATURE:
DATE: 02/22/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/22/2024


LIC809 (FAS) - (06/04)
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