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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 300603522
Report Date: 04/13/2023
Date Signed: 04/13/2023 12:32:24 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, 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
04/03/2023 and conducted by Evaluator Nguyen K Tran
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20230403164404
FACILITY NAME:GRACE HARBOR CHURCH AND SCHOOLFACILITY NUMBER:
300603522
ADMINISTRATOR:REBEKAH BAYFACILITY TYPE:
850
ADDRESS:12881 NEWPORT AVENUETELEPHONE:
(714) 544-4431
CITY:TUSTINSTATE: CAZIP CODE:
92780
CAPACITY:78CENSUS: 41DATE:
04/13/2023
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Rebehak Bay, DirectorTIME COMPLETED:
12:45 PM
ALLEGATION(S):
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Facility staff did not require authorized representative(s) to pick up ill child(ren).
INVESTIGATION FINDINGS:
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On 04/13/2023, Licensing Program Analysts (LPA) Tran and LPA Chan conducted na in-person investigation to deliver the finding regarding the above complaint allegation. LPA Tran met with Director Rebekah Bay. A toured the facility was conducted, and a census was taken. Observed at the time of the visit was a total of 41 preschool children and 6 staff members.

A review of the Facility Personnel Report Summary on 04/13/2023 indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

On 04/03/2023, the office received a complaint alleging facility staff did not require authorized representative(s) to pick up ill child(ren).

(Continue next page)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Rina Lopez
LICENSING EVALUATOR NAME: Nguyen K Tran
LICENSING EVALUATOR SIGNATURE:

DATE: 04/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/13/2023
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 3
Control Number 06-CC-20230403164404
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: 04/13/2023
NARRATIVE
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(Page 2 of Report)

During the investigation, LPAs interviewed 5 staffs on 04/06/2023 and reviewed record of facility's internal communication text messages and communication with children's representatives.

During interviews, LPAs learned that there were Child #1, who showed signs and symptoms of illness on 03/24/2023, 2 other children Child #2 and Child #3, who showed signs and symptoms of illness on 03/30/2023, and child # 4, who showed signs and symptoms of illness on 04/03/2023, while they were in care at the facility. All interviewed staff described procedure regarding illness as followed. When staff observed signs and symptoms of illness, staff will inform the management team, then the management will assess child and will contact the child's representatives to request for child to be picked up as needed. Staff will also post messages on Procare app to inform the parents after the management has assessed the situation.

During record review, LPAs reviewed records of the facility's internal communication text messages and facility communication records with children's representative. There were evidence that showed that facility contacted parents to inform of their child's illness. Child #1, who had an allergic reaction at approximately 9am, parents were notified via a phone call and messages on Pro Care app at 9:08am. Child was given medication by the parent and return to class. Child #2, who threw up the first time at approximately at 12:20pm, parents were informed via phone call and message at approximately 12:45pm. Child #2 threw up the 2nd time at approximately 3:25pm, and the parent were informed at 3:25pm via Procare message, parents arrived to picked up child #2 at approximately 3:56pm. Child #3 who had a fever at 4:29pm, parents were contacted at approximately 4:35pm via a phone call and a message on Procare at 4:48pm, child was picked up 5:16pm. Child #4 was assessed during drop off at 8:39am while parents were present in regarding possible illness. Parents informed the facility staff that they would arrange for child to picked up at 1:15pm to go to the doctor via Procare message at 9:34am.

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SUPERVISORS NAME: Rina Lopez
LICENSING EVALUATOR NAME: Nguyen K Tran
LICENSING EVALUATOR SIGNATURE:

DATE: 04/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/13/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 06-CC-20230403164404
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: 04/13/2023
NARRATIVE
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(Page 3 of Report)

Based on the interviews conducted with 5 staff on 04/06/2023, and record review of facility's internal communication text messages and communication records with children's representatives, there is insufficient evidence to corroborate the allegation that Facility staff did not require authorized representative(s) to pick up ill child(ren). Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove that facility staff did not require authorized representative(s) to pick up ill child(ren), did or did not occur, therefore the allegation that facility staff did not require authorized representative(s) to pick up ill child(ren) is UNSUBSTANTIATED.

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: 04/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/13/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3