300603522-4-26-2023-06-CC-RLOZ-CRBTWB-20230428150515

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 300603522
Report Date: 04/06/2023
Date Signed: 04/26/2023 02:51:25 PM

Substantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/05/2023 and conducted by Evaluator Nguyen K Tran

PUBLIC

COMPLAINT CONTROL NUMBER: 06-CC-20230405164231

FACILITY NAME:	GRACE HARBOR CHURCH AND SCHOOL		FACILITY NUMBER:	300603522
ADMINISTRATOR:	REBEKAH BAY		FACILITY TYPE:	850
ADDRESS:	12881 NEWPORT AVENUE		TELEPHONE:	(714) 544-4431
CITY:	TUSTIN	STATE: CA	ZIP CODE:	92780
CAPACITY:	78	CENSUS: 31	DATE:	04/06/2023
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Rebekah Bay, Director		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

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Daycare child was bitten by a rat due to lack of supervision.

INVESTIGATION FINDINGS:

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*** This is an amended report complete on 04/26/23 for the report written on 04/06/2023 to make correction on the LIC 9099D ***

On 04/06/2023, Licensing Program Analysts (LPA) Tran and LPA Chan conducted a 10-Day Initial Investigation regarding allegation about Daycare child was bitten by a rat due to lack of supervision. LPAs met with Director Rebekah Bay and informed the Director about the allegation.
A toured the facility was conducted, and a census was taken. Observed at the time of the visit was a total of 31 preschool children and 6 staff members.
A review of the Facility Personnel Report Summary on 04/06/2023 indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.
On 04/05/2023, the Regional office received a complaint alleging, Daycare child was bitten by a rat due to lack of supervision.

Substantiated

Estimated Days of Completion:

SUPERVISORS NAME: Rina Lopez
LICENSING EVALUATOR NAME: Nguyen K Tran
LICENSING EVALUATOR SIGNATURE:	DATE: 04/06/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/06/2023

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 4

Control Number 06-CC-20230405164231

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: GRACE HARBOR CHURCH AND SCHOOL	FACILITY NUMBER: 300603522
	VISIT DATE: 04/06/2023

NARRATIVE

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*** This page was amended on 04/26/23 from a report written on 04/06/23 ***
(Page 2 of Report)
During the investigation, LPAs conducted interviewed with 5 staff and one child.

During interviews, 2 out of 5 interviewed staff, were present at the playground on the day of the incident. Staff #3 (S3) and Staff #5 (S5) stated none of the teachers who were present, were aware of 3 children, Child #1(C1), Child #2 (C2) and Child #3 (C3) were playing with a dying rat, at the basketball court, approximately over 100 feet away from the teachers, until the teachers were informed by a non-client child, sibling of child #2. One staff disclosed that they heard from another staff about the incident. Director disclosed that staff reported about an incident when C1 was playing with a dying rat on the playground and got bitten by the rat. When Director interviewed C1, C1 said C1 got scratched by the rat. Director immediately informed C1's representative and C1 was taken to urgent care. When interviewed, C1 told LPA that C1 found a rat on the playground and was playing with the rat for a while, together with C2 and C3. C1 stated C1 was scratched by the rat, and C2 gave the dying rat a kiss. LPA informed the Director to ensure C2's representative was informed of the incident.

During record review, LPA reviewed facility schedule and communication of the facility with children's representatives regarding the incident. The children were scheduled to come to the playground at 3pm, staff did not know about the 3 children C1, C2, and C3 were playing with the rat until 3:50pm when C2 was picked up.

Based on LPA’s interview with 5 staff and one child and record review of facility's schedule, the preponderance of evidence standard has been met, therefore the above allegation that Daycare child was bitten by a rat due to lack of supervision, is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 12, Chapter 1, Section 101229(a)(1) Responsibility for Providing Care and Supervision is being cited on the attached 809D and an immediate civil penalty was assessed. This is a repeating violation which was previously cited on 03/29/2023 and on 03/09/2023.

Due to the Type A violation cited today, the Director shall post, and provide copies, of the report to parents/guardians of the children in care at the facility by the next business day, and shall provide to the parents/guardians of children newly enrolled at the facility during the next 12 months. The Director is to keep Acknowledgement Receipt (LIC 9224) signed by parents in each child’s file. In addition, the Director shall immediately post upon receipt the Proof of Correction for 30 consecutive days.
(Continue next page)

SUPERVISORS NAME: Rina Lopez
LICENSING EVALUATOR NAME: Nguyen K Tran
LICENSING EVALUATOR SIGNATURE:	DATE: 04/06/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/06/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 4

Control Number 06-CC-20230405164231

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: GRACE HARBOR CHURCH AND SCHOOL	FACILITY NUMBER: 300603522
	VISIT DATE: 04/06/2023

NARRATIVE

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(Page 3 of Report)

Appeal Rights were explained. The Director was provided a copy of appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days. First level appeals should be sent to the regional manager to the address listed above. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with Director Rebekah Bay.

(End of Report)

SUPERVISORS NAME: Rina Lopez
LICENSING EVALUATOR NAME: Nguyen K Tran
LICENSING EVALUATOR SIGNATURE:	DATE: 04/06/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/06/2023

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 06-CC-20230405164231

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: GRACE HARBOR CHURCH AND SCHOOL	FACILITY NUMBER: 300603522
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/06/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 04/10/2023 Section Cited CCR 101229(a)(1)	1 2 3 4 5 6 7	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. This requirement is not met evidenced by:	1 2 3 4 5 6 7	Director stated she had put in supervision plan in place immediately after the incident: The staff was instructed that the children are no longer allowed on the treeline area. Staff will be stationed in specific spots on the playground to be vigilant on children's activities on the playground.
	8 9 10 11 12 13 14	Based on LPAs' interviews, 2 interviewed staff were informed by a non-client child about 3 children were playing with a dying rat and the staff were not aware, and child #1 confirmed about the incident. This poses an immediate risk to health and safety of persons in care.	8 9 10 11 12 13 14	Director will submit the detailed plan to LPA by 04/10/2023.
CCR	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: Rina Lopez
LICENSING EVALUATOR NAME: Nguyen K Tran
LICENSING EVALUATOR SIGNATURE:	DATE: 04/06/2023

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/06/2023

LIC9099 (FAS) - (06/04)

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