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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304371198
Report Date: 10/15/2024
Date Signed: 10/15/2024 12:55:54 PM

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
09/30/2024 and conducted by Evaluator Nguyen K Tran
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20240930130548
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: 40DATE:
10/15/2024
UNANNOUNCEDTIME BEGAN:
09:20 AM
MET WITH:Gina Warren, DirectorTIME COMPLETED:
11:00 AM
ALLEGATION(S):
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Staff are not preventing inappropriate interaction between children.
INVESTIGATION FINDINGS:
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On 10/15/2024, Licensing Program Analyst (LPA) Tran and LPA Jung conducted a subsequent visit regarding the allegation about Staff are not preventing inappropriate interaction between children, and delivered finding. LPA Tran met with Director Gina Warren. A tour of the facility was conducted, and census was taken. Observed at the time of the investigation was a total of 34 preschool children with 5 staff in the preschool classrooms, 6 toddlers with 2 staff in the toddler's classroom. LPA informed the Director the purpose of the visit.

A review of the Facility Personnel Report Summary on 10/15/2024 indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

On 09/30/2024, Regional Office received a complaint regarding Staff are not preventing inappropriate interaction between children. (Continue next page)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Martha Malane
LICENSING EVALUATOR NAME: Nguyen K Tran
LICENSING EVALUATOR SIGNATURE:

DATE: 10/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2024
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 3
Control Number 06-CC-20240930130548
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: FIRST UNITED METHODIST CHURCH
FACILITY NUMBER: 304371198
VISIT DATE: 10/15/2024
NARRATIVE
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(Page 2 of Report)

During the investigation, LPA interviewed two staff members and reviewed children's files.

During interviews, both interviewed staff members confirmed that there were multiple incidents in which Child #2 (C2) and Child #3 (C3) exhibited aggressive behaviors towards other children. Interviewed staff stated they provided interventions including taking C2 and C3 out of the classrooms for a walk and talk to assist the children to calm down before letting them going back to class. During the interview, Director stated the facility has developed a behavioral plan for C3 starting in 09/2024 and Director admitted that the behavioral plan should have been in place to assist C2 and C3 to manage the challenging behaviors sooner. Director stated the facility is currently working with C2's guardians to develop a behavioral plan for C2.

During record review, LPA reviewed C2's and C3's files. The file revealed that C2 had multiple incident reports between 04/2022 to 09/2024, in which, C2 exhibited aggressive behaviors towards others. C3's file also revealed that C3 had multiple incident reports, in which C3 exhibited aggressive behaviors towards others from 02/2023 to 10/2024. Although there was a behavioral plan to be implemented starting 09/2024 for C3, C3 continued to have behavioral incident reports in 09/2024 and 10/2024.

Based on information gathered from LPA's interviews and record reviews, the preponderance of evidence standard has been met, therefore the above allegation about Staff are not preventing inappropriate interaction between children, is found to be substantiated. California Code of Regulations, Title 22, Division 12 & Chapter 1, Section 101223(a)(2) Personal Rights cited on the attached LIC9099D.

Appeal Rights and deficiency were discussed. The facility representative was provided a copy of their 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. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with Director Gina Warren.

(End of Report)
SUPERVISORS NAME: Martha Malane
LICENSING EVALUATOR NAME: Nguyen K Tran
LICENSING EVALUATOR SIGNATURE:

DATE: 10/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 06-CC-20240930130548
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: FIRST UNITED METHODIST CHURCH
FACILITY NUMBER: 304371198
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/15/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/22/2024
Section Cited
CCR
101223(a)(2)
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101223 Personal Rights (a) The licensee shall ensure that each child is accorded the following personal rights: (2) To be accorded safe, healthful and comfortable accommodations... to meet his/her needs. This requirement is not met eveidenced by:
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Director states she will submit a behavioral plan for C2 and will submit updates in facility's policy and procedures regarding to managing challenging behaviors, to LPA by due date.
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Based on interviews and record reviews, C2 and C3 had multiple incident reports, in which, both C2 and C3 exhibited aggressive behaviors towards others for approximately 1-2 years while attending facility, and facility did not have a plan to timely address and assist C2 and C3 in managing the challenging behaviors. This posed a potential risk to the health, safety and personal rights to 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: Martha Malane
LICENSING EVALUATOR NAME: Nguyen K Tran
LICENSING EVALUATOR SIGNATURE:

DATE: 10/15/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2024
LIC9099 (FAS) - (06/04)
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