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

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198014862
Report Date: 04/07/2022
Date Signed: 07/13/2022 04:16:13 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/01/2022 and conducted by Evaluator Elka Chavez
COMPLAINT CONTROL NUMBER: 54-CC-20220401085657
FACILITY NAME:CALVARY CHAPEL CHRISTIAN PRESCHOOLFACILITY NUMBER:
198014862
ADMINISTRATOR:BLANCA SANCHEZFACILITY TYPE:
850
ADDRESS:12808 WOODRUFF AVENUETELEPHONE:
(562) 299-9100
CITY:DOWNEYSTATE: CAZIP CODE:
90242
CAPACITY:95CENSUS: 81DATE:
04/07/2022
UNANNOUNCEDTIME BEGAN:
09:50 AM
MET WITH:Christy LeonardTIME COMPLETED:
05:20 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility failed to notify child's authorized representative of type A deficiencies.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
** This report is an amended report to change the findings from substantiated to unsubstatiated.
Licensing Program Analyst (LPA) Elka Chavez conducted an unannounced complaint inspection on April 07, 2022 at 9:50 AM. LPA met with Facility Representative, Denisse Cardenas to discuss the above allegation. At the time of arrival LPA observed 81 children in care with 8 staff.
At 9:55 AM LPA toured the facility. Facility representative, Denisse Cardenas stated that the facility has copies of the licensing reports in the preschool office to give to parents. The reports may have been uploaded into the application used by the childrens authorized representatives. The facility was unable to confirm if the reports were uploaded into the application used by parents.

Based on LPA’s observations and interviews which were conducted and record review(s), the preponderance of the evidence standard has been met, therefore the above allegation(s) is found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division 12 & Chapter 3.4 (CCC) are being cited on the attached LIC9099D
Unsubstantiated
Estimated Days of Completion: 0
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Elka Chavez
LICENSING EVALUATOR SIGNATURE:

DATE: 04/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/07/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 54-CC-20220401085657
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: CALVARY CHAPEL CHRISTIAN PRESCHOOL
FACILITY NUMBER: 198014862
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/07/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/15/2022
Section Cited
HSC
1596.8595(c)(1)
1
2
3
4
5
6
7
1596.8595(c)(1) Posting licensing report by child care facility or home:
(c)(1) A licensed child day care facility shall provide to the parents or guardians of each child receiving services in the facility copies of any licensing report that documents any Type A citation that represents an immediate risk to the health, safety, or personal rights of children in care as set forth in paragraph (1) of subdivision (a) of Section 1596.893b
This requirement is not met as evidenced by:
1
2
3
4
5
6
7
Director Denisse Cardenas will provide parents with the LIC9224 form and a copy of the licensing report. A copy of the signed forms will be provided to LPA by POC due date via email.
8
9
10
11
12
13
14
Based on interviews, the facility representative did not comply with the section cited above in children in care poses a potential health, safety or personal rights risk to persons in care.
8
9
10
11
12
13
14
AMENDED REPORT: CHANGED TO UNSUBSTANTIATED. NO CITATIONS ISSUED.
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: Karen Chambers
LICENSING EVALUATOR NAME: Elka Chavez
LICENSING EVALUATOR SIGNATURE:

DATE: 04/07/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/07/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2