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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304371197
Report Date: 07/18/2023
Date Signed: 07/18/2023 09:06:05 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 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
05/17/2023 and conducted by Evaluator Romelia M Castanon
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20230517163735
FACILITY NAME:KING OF GLORY LUTHERAN CHURCH & PRESCHOOLFACILITY NUMBER:
304371197
ADMINISTRATOR:DANIELS, STEPHANIEFACILITY TYPE:
830
ADDRESS:10280 SLATER AVENUETELEPHONE:
(714) 968-5865
CITY:FOUNTAIN VALLEYSTATE: CAZIP CODE:
92708
CAPACITY:12CENSUS: 5DATE:
07/18/2023
UNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Director Stephanie Daniels TIME COMPLETED:
09:30 AM
ALLEGATION(S):
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Smoking Probhibition
INVESTIGATION FINDINGS:
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On 07/18/2023, Licensing Program Analyst (LPA) Romy Castanon made an unannounced visit to the facility for the purpose to deliver findings of a complaint that was received at the Orange County Regional Child Care Program Office. LPA met with Director Stephanie Daniels and explained the reason for today’s visit. A tour of Infant Yellow classroom was conducted, and census was taken. Observed at the time of the visit was a total of 5 infants and 2 staff members.
A review of the Facility Personnel Report Summary on 07/18/2023 indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

On 05/23/2023, Orange County Regional Office received a complaint that facility staff are smoking vape pens in the presence of infants. Complaint stated that staff are smoking electronic cigarettes or vapes in the infant nap room. LPA was unable to contact Reporting Party for interview so no additional information was obtained.
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Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Rina Lopez
LICENSING EVALUATOR NAME: Romelia M Castanon
LICENSING EVALUATOR SIGNATURE:

DATE: 07/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2023
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-20230517163735
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: KING OF GLORY LUTHERAN CHURCH & PRESCHOOL
FACILITY NUMBER: 304371197
VISIT DATE: 07/18/2023
NARRATIVE
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During initial 10-day visit, on 05/22/2023, LPA interviewed Director and four staff members. Director stated there was an all-staff meeting held on 03/17/2023. During this meeting a CPR training was conducted and an annual review of facility policies and procedures. Facility provided staff with their “Smoke Free Workplace Policy” which was signed and dated by all staff members. The facility property also has “No Smoking” warning signs posted in public accessible area for all to see. Director denied any knowledge that staff were smoking on campus.

During staff interviews, two staff members disclosed witnessing Staff #1 (S1) smoking their vape pen in both, infant classroom and infant nap room. Staff #2 (S2) stated about two months ago the infant room smelled weird. S2 observed S1 smoking and instructed S1 not to ever smoke in the room again. S2 stated they spoke to S1 directly but did not mention the incident to management. LPA asked S1 about the incident, S1 stated a staff member observed their vape pen hiding on their wrist while in the infant nap room. S1 stated that staff member discussed the dangers of smoking but states they do not smoke on campus. LPA asked S1 if they had their vape pen with them and S1 confirmed it was in their pant pocket during the interview.

Based on interviews conducted with staff members, the preponderance of evidence standard has been met, therefore the smoking prohibition allegation that facility staff are smoking vape pens in the presence of infants is found to be substantiated. California Code of Regulations, Title 22, Division 12, 101231(a) Smoking Prohibition is being cited on the attached LIC9099D.



Exit interview was conducted with Director Stephanie Daniels. Notice of Site Visit was posted during the visit. Director was informed that the notice of site visit must be posted for 30 days. Director was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these rights.

End of Report
SUPERVISORS NAME: Rina Lopez
LICENSING EVALUATOR NAME: Romelia M Castanon
LICENSING EVALUATOR SIGNATURE:

DATE: 07/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 06-CC-20230517163735
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: KING OF GLORY LUTHERAN CHURCH & PRESCHOOL
FACILITY NUMBER: 304371197
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/18/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/21/2023
Section Cited
CCR
101231(a)
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101231 Smoking Prohibition (a) Smoking is prohibited on the premises of a child care center as specified in Health and Safety Code Section 1596.795(b). This requirement was not met as evidenced by:
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Director will formal disciplinary action notice to S1 and submit a copy to LPA by POC due date. DIrector will also reiterate complaint findings and remind staff of smoking policy including termination of employment. Director will meet one on one with staff members and send the updated smoking policy to LPA by POC date.
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During LPA interviews, 2 out of 2 staff members stated they have observed S1 smoking in the presence of infants. This poses a potential risk to the personal or health and safety 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.
SUPERVISORS NAME: Rina Lopez
LICENSING EVALUATOR NAME: Romelia M Castanon
LICENSING EVALUATOR SIGNATURE:

DATE: 07/18/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2023
LIC9099 (FAS) - (06/04)
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