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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 300606476
Report Date: 10/25/2024
Date Signed: 10/25/2024 10:20:26 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY CC RO, 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
09/27/2024 and conducted by Evaluator Anna Francesca Chan
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20240927090647
FACILITY NAME:GRACE HARBOR CHURCH AND SCHOOLFACILITY NUMBER:
300606476
ADMINISTRATOR:REBEKAH BAYFACILITY TYPE:
830
ADDRESS:12881 NEWPORT AVENUETELEPHONE:
(714) 544-4431
CITY:TUSTINSTATE: CAZIP CODE:
92780
CAPACITY:16CENSUS: 7DATE:
10/25/2024
UNANNOUNCEDTIME BEGAN:
08:55 AM
MET WITH:Director Rebekah BayTIME COMPLETED:
10:35 AM
ALLEGATION(S):
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9
Reporting Requirement
INVESTIGATION FINDINGS:
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On 10/25/2024, at 8:55AM Licensing Program Analyst (LPA) Anna Chan conducted an unannounced Complaint investigation inspection. This to deliver findings of the investigation initiated on 10/1/2024. Upon arrival, the LPA met with Director Rebekah Bay. LPA informed director of the purpose of visit and LPA was led on walkthrough of the facility and a census was taken. LPA observed 3 staff and 7 infant children.

The Department received a complaint on 9/27/2024 alleging staff do not ensure reporting requirements are being followed.

Page 1 of 2
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Martha Malane
LICENSING EVALUATOR NAME: Anna Francesca Chan
LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2024
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 06-CC-20240927090647
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: GRACE HARBOR CHURCH AND SCHOOL
FACILITY NUMBER: 300606476
VISIT DATE: 10/25/2024
NARRATIVE
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LPA interviewed staff at the facility. Staff 1 (S1) stated they opened the door connecting from toddler room to infant room and Child 1 (C1) walked through the door and pushed Child 2 (C2) and grab C2 by the neck. Staff 4 (S4) and Staff 5 (S5) stated they redirected C1 away from C2. S1 stated the facility did not report the incident to C1’s authorized representative. Incidents were reported to C1’s authorized representative a few days after occurrence. Facility staff did not follow reporting requirement or unusual incident report according to California Code of Regulations Title 22.

None of the parents interviewed disclosed any information that supported the allegation.

Based on the LPA’s conducted interviews and record reviews, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. A substantiated finding means that the complaint is substantiated, and the allegation is valid because the preponderance of the evidence standard has been met. See LIC9099D for a Type B deficiency cited.

An exit interview was conducted with Director, Rebekah Bay. The Notice of Site Visit was posted during the visit. The director was informed that the Notice of Site Visit must be posted for 30 consecutive days. Failure to post will result in civil penalties of $100. The director was provided a copy of their appeal rights (LIC 9058 01/16) and their signature on this form acknowledges receipt of these rights. First-level appeals should be sent to the regional manager to the address listed above.

Page 2 of 2
SUPERVISORS NAME: Martha Malane
LICENSING EVALUATOR NAME: Anna Francesca Chan
LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2024
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
ORANGE COUNTY CC RO, 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
09/27/2024 and conducted by Evaluator Anna Francesca Chan
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20240927090647

FACILITY NAME:GRACE HARBOR CHURCH AND SCHOOLFACILITY NUMBER:
300606476
ADMINISTRATOR:REBEKAH BAYFACILITY TYPE:
830
ADDRESS:12881 NEWPORT AVENUETELEPHONE:
(714) 544-4431
CITY:TUSTINSTATE: CAZIP CODE:
92780
CAPACITY:16CENSUS: 7DATE:
10/25/2024
UNANNOUNCEDTIME BEGAN:
08:55 AM
MET WITH:Director Rebekah BayTIME COMPLETED:
10:35 AM
ALLEGATION(S):
1
2
3
4
5
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7
8
9
Staff do not ensure adequate supervision is provided to children resulting in a child getting bit by another child in care
INVESTIGATION FINDINGS:
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On 10/25/2024, at 8:55AM Licensing Program Analyst (LPA) Anna Chan conducted an unannounced Complaint investigation inspection to deliver findings of the investigation initiated on 10/1/2024. Upon arrival, LPA met with Director, Rebekah Bay. LPA informed director of the purpose of visit and was led on walkthrough of the facility and a census was taken. LPA observed 3 staff and 7 infant children.

The Department received a complaint on 9/27/2024 alleging staff do not ensure adequate supervision is provided to children resulting in a child getting bit by another child in care.

Page 1 of 2
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Martha Malane
LICENSING EVALUATOR NAME: Anna Francesca Chan
LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2024
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 06-CC-20240927090647
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: GRACE HARBOR CHURCH AND SCHOOL
FACILITY NUMBER: 300606476
VISIT DATE: 10/25/2024
NARRATIVE
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LPA interviewed staff at the facility. Staff interviewed stated supervision is provided at all times. If a child attempts to bite another child, staff redirects the children to prevent a bite. Staff stated that if a child bites and leaves a mark, a message is sent to parents through Procare for both parties. Staff stated they have observed Child 1 (C1) attempt to bite, C1's authorized representative was notified.

None of the parents interviewed disclosed any information that supported the allegation.

Based on interviews conducted and record reviews, the preponderance of evidence standard has not been met. Although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

An exit interview was conducted with Director, Rebekah Bay. The Notice of Site Visit was posted during the visit. The director was informed that the Notice of Site Visit must be posted for 30 consecutive days. Failure to post will result in civil penalties of $100. The director was provided a copy of their appeal rights (LIC 9058 01/16) and their signature on this form acknowledges receipt of these rights. First-level appeals should be sent to the regional manager to the address listed above.

Page 2 of 2
SUPERVISORS NAME: Martha Malane
LICENSING EVALUATOR NAME: Anna Francesca Chan
LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2024
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 06-CC-20240927090647
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: GRACE HARBOR CHURCH AND SCHOOL
FACILITY NUMBER: 300606476
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/25/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/25/2024
Section Cited
CCR
101212(f)
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101212(f) Reporting Requirements
(f) The items specified in (d)(1)(A) through (H) above shall also be reported to the child's authorized representative.

This requirement is not met as evidenced by:
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Director stated they will send LPA a document stating any unusual incidents will be reported to Children's Authorized Representatives and will add notes to Procare about any incidents.
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Based on staff interviews and record reviews, the facility did not report to Child 1's (C1) authorized representative (AR) about an unusual incident that occurred between C1 and C2 in the classroom. Report was given upon the request of AR.
This poses a potential risk to health and safety of children in care.
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 Director stated they will look into revisiting with Startwell in dealing well with children and families.
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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: Martha Malane
LICENSING EVALUATOR NAME: Anna Francesca Chan
LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2024
LIC9099 (FAS) - (06/04)
Page: 5 of 5