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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304371198
Report Date: 04/20/2023
Date Signed: 04/20/2023 02:07:27 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
02/27/2023 and conducted by Evaluator Nguyen K Tran
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20230227100252
FACILITY NAME:FIRST UNITED METHODIST CHURCHFACILITY NUMBER:
304371198
ADMINISTRATOR:CHERI PAYNEFACILITY TYPE:
850
ADDRESS:161 SOUTH ORANGETELEPHONE:
(714) 316-5933
CITY:ORANGESTATE: CAZIP CODE:
92866
CAPACITY:60CENSUS: 53DATE:
04/20/2023
UNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Cheri Payne, DirectorTIME COMPLETED:
12:30 PM
ALLEGATION(S):
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Staff do not provide adequate supervision to children in care.
Staff did not report incident to Licensing.
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPA) Nguyen Tran conducted a subsequent investigation at the facility and delivered the complaint findings. LPA met with Director Cheri Payne. Census was taken in individual classrooms. The overall census observed was 45 preschool children and 8 toddlers supervised by 7 staff in 5 classrooms.

A review of staff criminal clearance records on 04/20/2023, indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

On 02/27/2023 a complaint was filed with the Licensing office alledge, staff do not provide adequate supervision to children in care, and staff did not report incident to Licensing.
(Continue next page)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Rina Lopez
LICENSING EVALUATOR NAME: Nguyen K Tran
LICENSING EVALUATOR SIGNATURE:

DATE: 04/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2023
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 6
Control Number 06-CC-20230227100252
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: FIRST UNITED METHODIST CHURCH
FACILITY NUMBER: 304371198
VISIT DATE: 04/20/2023
NARRATIVE
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(Page 2 of Report)

During the investigation, LPA interviewed 5 staffs on 03/01/2023, and interviewed 2 staff on 04/20/2023.

During a confidential interview, it was reported that there were 2 incidents that occurred when a child was left unsupervised. Incident #1 was reported that child # 1 (C1) was left behind unsupervised, when Glassell classroom's teacher transitioned the group of children from the outdoor playground into the classroom. Incident #2 was reported that a group of 5 toddlers was supervised by one teacher, a preschool child, child # 2 (C2) opened the latch to the gate that separated the toddler yard and the preschool yard and a toddler, child # 3 (C3) went over to the preschool playground, and the toddler was brought back into the toddler playground by the preschool teacher.

During the interviews regarding incident #1, 2 out of 7 interviewed staffs, staff #3 (S3) and staff # 6 (S6) witnessed the incident. The two staff, S3 and S6, both described that when the teacher in the Glassell classroom lined up the children to bring them inside, child #1 (C1) was left behind. However, C1 was supervised by S3 and S6, who were still in the playground and S3 brought C1 back into the Glassell classroom right the way.

During the interviews regarding incident #2, 2 of out 7 interviewed staff, staff #1 (S1) and staff #5 (S5) witnessed the incident #2, when they saw C2 opened the latch of the gate and C3 went over to the preschool playground, and S5 immediately brought C3 back into the toddler yard and informed the toddler teacher.

When interviewed, Director stated in both incidents, C1 and C3 were supervised at all time. In incident #1, although C1 was left outside by C1's teacher, C1 was supervised by S3 adn S5 and S3 brought C1 into Glassell's classroom right the way. In incident #2, C3 was witnessed going over to the preschool playground and was brought back to the toddler teacher immediately. Director also stated that a meeting was held to address the concern with the teacher who involved in the 2 incident to address the supervision. Director did not report the 2 incidents to Community Care Licensing due to the fact that the children were not left unsupervised, but did take action to address concern internally.

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

DATE: 04/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 6
Control Number 06-CC-20230227100252
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: FIRST UNITED METHODIST CHURCH
FACILITY NUMBER: 304371198
VISIT DATE: 04/20/2023
NARRATIVE
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(Page 3 of Report)

Based on the information gathered from LPA's interviews on 03/01/2023 and on 04/20/2023, there is insufficient evidence to corroborate the allegations that Staff do not provide adequate supervision to children in care and Staff did not report incident to Licensing. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged, Staff do not provide adequate supervision to children in care and Staff did not report incident to Licensing, did or did not occurred, therefore, the allegations that Staff do not provide adequate supervision to children in care and Staff did not report incident to Licensing, are UNSUBSTANTIATED.

Exit interview was conducted. The Notice of Site Visit was posted. Appeal Rights was explained. A copy of appeal rights (LIC 9058) was provided. First level appeal is to Regional Manager, address is above on the report.

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

DATE: 04/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 6
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
02/27/2023 and conducted by Evaluator Nguyen K Tran
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20230227100252

FACILITY NAME:FIRST UNITED METHODIST CHURCHFACILITY NUMBER:
304371198
ADMINISTRATOR:CHERI PAYNEFACILITY TYPE:
850
ADDRESS:161 SOUTH ORANGETELEPHONE:
(714) 316-5933
CITY:ORANGESTATE: CAZIP CODE:
92866
CAPACITY:60CENSUS: 53DATE:
04/20/2023
UNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Cheri Payne, DirectorTIME COMPLETED:
12:30 PM
ALLEGATION(S):
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Unqualified staff are providing care and supervision alone.
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPA) Nguyen Tran conducted a subsequent investigation at the facility and delivered the complaint findings. LPA met with Director Cheri Payne. Census was taken in individual classrooms. The overall census observed was 45 preschool children and 8 toddlers supervised by 7 staff in the 5 classrooms.

A review of staff criminal clearance records on 04/20/2023, indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

On 02/27/2023 a complaint was filed with the Licensing office alledge, Unqualified staff are providing care and supervision alone.
(Continue next page)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Rina Lopez
LICENSING EVALUATOR NAME: Nguyen K Tran
LICENSING EVALUATOR SIGNATURE:

DATE: 04/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 6
Control Number 06-CC-20230227100252
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: FIRST UNITED METHODIST CHURCH
FACILITY NUMBER: 304371198
VISIT DATE: 04/20/2023
NARRATIVE
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(Page 2 of Report)

During the investigation, LPA interviewed 5 staffs on 03/01/2023 and interviewed 2 staff on 04/20/2023, and reviewed staff's records.

During a confidential interview, it was reported that staff # 4 (S4) who did not have Infant and Toddler units, were providing care for the toddlers alone.

During interviews, staff #4 admitted that S4 was providing care for 2 toddlers on 02/22/2023 for approximately 30-45 minutes, while Director were meeting with the main teacher and this was the only period of time that S4 ever worked alone with the toddlers. Director also confirmed that Director met with the main teacher for about 30 minutes while S4 was providing care for the toddlers in the classroom. All other interviewed staff denied witnessing S4 worked alone with the toddlers in any occasion.

During record reviews, LPA discovered that S4 did not have any Infant and Toddler unit.

Based on the information gathered from LPA's interviews with 5 staff on 03/01/2023 and on 04/20/2023, and record review of 11 staff files on 03/01/2023, the preponderance of evidence standard has been met, therefore the above allegation, unqualified staff are providing care and supervision alone, is found to be Substantiated. California Code of Regulations, Title 22 Division 12 Chapter 1, Sub Chapter 2 Section 101416.2 (b) Infant Care Teacher Qualifications and Duties is being cited on the attached LIC 9099D.

Exit interview was conducted. The Notice of Site Visit was posted. Appeal Rights was explained. A copy of appeal rights (LIC 9058) was provided. First level appeal is to Regional Manager, address is above on the report.

(End of Report)

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

DATE: 04/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2023
LIC9099 (FAS) - (06/04)
Page: 5 of 6
Control Number 06-CC-20230227100252
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: FIRST UNITED METHODIST CHURCH
FACILITY NUMBER: 304371198
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/20/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/27/2023
Section Cited
CCR
101416.2(b)
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101416.2 Infant Care Teacher Qualifications and Duties (b) Prior to employment, an infant care teacher shall have completed... three... units related to the care of infants...

This requirement was not met evidenced by:
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Director states that she will submit a statement of understanding of the regulation and provide a detailed plan to ensure this regulation is being met, to LPA by due date.
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Based on LPAs interviews and record review, Staff #4 did not meet qualification to work in the toddler classroom and had provided care for 2 toodlers in the the toddler classroom alone, for more than 30 minutes, this posed a potential risk to the health, safety and personal rights of the 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: Nguyen K Tran
LICENSING EVALUATOR SIGNATURE:

DATE: 04/20/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2023
LIC9099 (FAS) - (06/04)
Page: 6 of 6