304371197-12-16-2025-06-CC-NKTN-DPH2AM-20251218161344

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 304371197
Report Date: 12/16/2025
Date Signed: 12/16/2025 10:17:04 AM

Unsubstantiated

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
08/13/2025 and conducted by Evaluator Dianna ValdezSantana

PUBLIC

COMPLAINT CONTROL NUMBER: 06-CC-20250813102954

FACILITY NAME:	KING OF GLORY LUTHERAN CHURCH & PRESCHOOL		FACILITY NUMBER:	304371197
ADMINISTRATOR:	DANIELS, STEPHANIE		FACILITY TYPE:	830
ADDRESS:	10280 SLATER AVENUE		TELEPHONE:	(714) 968-5865
CITY:	FOUNTAIN VALLEY	STATE: CA	ZIP CODE:	92708
CAPACITY:	12	CENSUS: 10	DATE:	12/16/2025
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:			TIME COMPLETED:	10:30 AM

ALLEGATION(S):

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Staff did not provide adequate supervision resulting in day care child sustaining a fracture.
Staff did not report incident to child's authorized representatives.

INVESTIGATION FINDINGS:

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On 12/15/2025 Licensing Program Analyst (LPA) Valdez Santana conducted an unannounced inspection for the purpose of delivering complaint findings for the complaint investigation that was conducted by Investigation Branch (IB) Investigator Jorge Rojas and by LPA Valdez Santana. Upon arrival, LPA met with Director, Stephanie Daniels who guided LPA on a tour of the facility and LPA conducted a census. LPA observed 4 staff caring for 10 infant children in the childcare area.

A review of staff records on this date indicated that all facility staff or other individuals who required caregiver background checks have received criminal record and child abuse index clearances or exemptions.

On 8/13/2025, the Department received a complaint alleging (1) Staff did not provide adequate supervision resulting in day care child sustaining a fracture and (2) Staff did not report incident to child's authorized representatives. Page 1 of 4

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Tina Nguyen
LICENSING EVALUATOR NAME: Dianna ValdezSantana
LICENSING EVALUATOR SIGNATURE:	DATE: 12/16/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2025

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-20250813102954

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: KING OF GLORY LUTHERAN CHURCH & PRESCHOOL	FACILITY NUMBER: 304371197
	VISIT DATE: 12/16/2025

NARRATIVE

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Page 2

The Reporting Party (RP) stated that Child #1 (C1) was reported being fussy on 8/7/2025, and day care staff provided extra care but did not report any injury. On 8/10/2025, C1 was taken to urgent care for redness on the left arm, where an X-ray showed a broken collarbone. On 8/11/2025, staff informed the RP that C1 had fallen from a climbing set on 8/7/2025.

During the investigation, IB Investigator Rojas interviewed the child's representatives, facility's staff and parents of enrolled children. Investigator Rojas also reviewed medical records and reports from Child Welfare Services.

Regarding the allegation, Staff did not provide adequate supervision resulting in day care child sustaining a fracture, during the interviews, three staff reported being present during the incident when C1 fell. Staff #2 (S2) reported that C1 had been playing on the foam playscape for several minutes when C1 fell from the first step onto a carpeted mat. S2 was the only staff member who witnessed the fall and stated they were about four feet away, and informed Staff #1 (S1). S1 picked up C1 immediately, soothed C1, and checked for bumps or bruises but found none. S1 said C1 stopped crying quickly and appeared fine. After a nap, C1 became fussy and looked sick, which staff believed was due to an illness circulating in the classroom. Staff #3 (S3) stated C1’s representative was notified through the Lilio app that C1 was fussy and that staff were giving C1 extra cuddles. Staff #4 (S4) reported S4 was informed of the fall from S1, S2 and S3, and S4 was also informed by C1’s representative that C1 was taken into urgent care on 08/08/2025 for fussiness and again on 08/10/2025, when C1 was diagnosed with a broken collarbone. All staff interviewed stated they would follow procedures to assess children for injuries after a fall incident and notify children’s representatives accordingly.

C1’s representative (P1) reported that on 08/07/2025, staff noted through the Lilio app that C1 seemed unwell. At pick-up, C1 was on S1’s lap with a red face, as if previously crying. C1 was fussy and had diarrhea at home. On 08/08/2025, C1 had no illness symptoms but did not want to move and was not acting normally, so P1 took C1 to urgent care, where medical staff suggested flu or COVID and moved C1’s arms during the exam. On 08/09/2025, during a trip to Big Bear, C1 was observed to be playful but avoided using the left arm. P1 then noticed slight redness and swelling on C1’s collarbone. On 08/10/2025, C1 was taken to urgent care where X-rays revealed a broken collarbone. Page 2 of 4

SUPERVISORS NAME: Tina Nguyen
LICENSING EVALUATOR NAME: Dianna ValdezSantana
LICENSING EVALUATOR SIGNATURE:	DATE: 12/16/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2025

LIC9099 (FAS) - (06/04)

Page: 2 of 4

Control Number 06-CC-20250813102954

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: KING OF GLORY LUTHERAN CHURCH & PRESCHOOL	FACILITY NUMBER: 304371197
	VISIT DATE: 12/16/2025

NARRATIVE

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Page 3

On 08/11/2025, P1 spoke with facility staff, who stated C1 fell from the second step of the foam playscape, which P1 felt did not match the incident report. P1 said the urgent care doctor believed the injury could have been accidental and did not suspect abuse.

Interview with Adult #1 (A1), a medical professional, indicated that a collarbone fracture could be consistent with a fall from the foam playscape. The fall from the first step of the playscape was determined to be accidental and not the result of neglect or inadequate supervision. Due to the delay in seeking medical treatment, it could not be determined when C1 sustained the fracture. The County of Orange Children and Family Services (COCFS) subsequently closed their investigation as Unfounded for both physical abuse and neglect.

Based on information gathered from IB’s report, medical report, and COCFS’s Investigation Narrative report, the preponderance of Child sustained fracture while in care has not been met. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur; therefore, the allegation is UNSUBSTANTIATED.

During the investigation, LPA Valdez Santana interviewed four (4) staff members and four (4) parents. Children were not interviewed due to being nonverbal. LPA obtained a copy of the children’s roster, personnel report, copy of child #1 (C1's) file, copy of incident report, copy of screenshot from Lillio app and four (4) staff written statements.

Regarding the allegation, Staff did not report incident to child's authorized representatives, four (4) out of four (4) interviewed staff disclosed that staff communicate with parents daily through the Lillio app and in-person at drop off and pick up. All interviewed staff provided consistent statements regarding reporting incident to children’s authorized representatives as stated in facility’s policy and procedures. Four (4) out of four (4) interviewed parents stated they had no concerns about the facility and did not disclose any information related to the allegation.

Page 3 of 4

SUPERVISORS NAME: Tina Nguyen
LICENSING EVALUATOR NAME: Dianna ValdezSantana
LICENSING EVALUATOR SIGNATURE:	DATE: 12/16/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2025

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 06-CC-20250813102954

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: KING OF GLORY LUTHERAN CHURCH & PRESCHOOL	FACILITY NUMBER: 304371197
	VISIT DATE: 12/16/2025

NARRATIVE

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Page 4

Based on IB's and LPA's interviews and observations, there is not a preponderance of evidence to prove that Staff did not provide adequate supervision resulting in day care child sustaining a fracture and Staff did not report incident to child's authorized representatives. Based on the information gathered from IB’s and LPA'’ interviews, observation, and records reviewed, the preponderance of the evidence has not been met. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations of Staff did not provide adequate supervision resulting in day care child sustaining a fracture and Staff did not report incident to child's authorized representatives, therefore, the allegations are UNSUBSTANTIATED.

Exit interview was conducted with Director, Stephanie Daniels. The Notice of Site Visit was posted. Facility representative was informed that the Notice of Site Visit must be posted for 30 consecutive days. Licensee was provided with a copy of their appeal rights (LIC 9058) 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 4 of 4. End of Report.

SUPERVISORS NAME: Tina Nguyen
LICENSING EVALUATOR NAME: Dianna ValdezSantana
LICENSING EVALUATOR SIGNATURE:	DATE: 12/16/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2025

LIC9099 (FAS) - (06/04)

Page: 4 of 4