334818811-2-5-2026-10-CC-DMUN-DREPBH-20260218101020

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 334818811
Report Date: 02/05/2026
Date Signed: 02/05/2026 12:28:46 PM

Substantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/02/2026 and conducted by Evaluator Jesse Gardner

COMPLAINT CONTROL NUMBER: 10-CC-20260202153031

FACILITY NAME:	CALVARY CHAPEL ACADEMY PRESCHOOL		FACILITY NUMBER:	334818811
ADMINISTRATOR:	MICHELLE CORTES		FACILITY TYPE:	850
ADDRESS:	26121 HEMET STREET		TELEPHONE:	(951) 927-4395
CITY:	HEMET	STATE: CA	ZIP CODE:	92544
CAPACITY:	54	CENSUS: 20	DATE:	02/05/2026
		UNANNOUNCED	TIME BEGAN:	08:34 AM
MET WITH:	Michelle Cortes, Director		TIME COMPLETED:	12:47 PM

ALLEGATION(S):

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Authorized representative was not notified their child sustained an injury while in care.
Facility did not ensure child was offered clean clothes.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Jesse Gardner conducted an unannounced complaint visit to the facility. LPA met with Executive Director Angie Kubel, and later Director Michelle Cortes and informed them of the purpose of this visit. During this investigation LPA conducted interviews with the Executive Director, Director, staff and Child One (C1), and reviewed audio/video footage.

It was alleged that C1 fell out of their chair and sustained an injury and C1's authorized representative was not notified. LPA interviewed 3 staff, and 2 of 2 staff who were present stated the incident occurred approximately between 11:15AM - 11:30AM when

Continued on LIC9099-C

Substantiated

Estimated Days of Completion:

SUPERVISORS NAME: Deborah Mullen
LICENSING EVALUATOR NAME: Jesse Gardner
LICENSING EVALUATOR SIGNATURE:	DATE: 02/05/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/05/2026

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 10-CC-20260202153031

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: CALVARY CHAPEL ACADEMY PRESCHOOL	FACILITY NUMBER: 334818811
	VISIT DATE: 02/05/2026

NARRATIVE

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C1 fell out of their chair and sustained injury. Interview with the Director revealed C1 had told the Director of the injury and pointed to evidence of the injury; however, C1's authorized representative was not immediately notified. Medical records obtained confirmed C1 sustained injury when falling off of the chair.

It was alleged the facility did not ensure C1 was offered clean clothes. This allegation was in relation to the incident where C1 was injured. LPA interviewed 2 staff, and 1 staff stated they didn't think to change C1, and the other staff stated there was too little evidence to warrant a change of C1's underwear. Ultimately, staff stated C1 should have been changed at the conclusion of the incident. Confidential, and staff interviews revealed C1 had an additional set of clean clothes and pull-ups available each day for C1 to wear should the need arise.

The facility did not ensure C1's authorized representative was notified immediately after evidence of an injury occurred, and the child was not afforded safe, healthful, and comfortable accommodations to meet their needs. Thus the allegations are Substantiated. A finding that the complaint is Substantiated means that the allegations are valid because the preponderance of the evidence standard has been met.

An exit interview was conducted, and a copy of this report was provided along with copies of the LIC9099-D (deficiency page), LIC811 (confidential names list), and Appeal Rights was provided. A Notice of Site visit was given, and the Licensee understands that it must remain posted for 30 days.

SUPERVISORS NAME: Deborah Mullen
LICENSING EVALUATOR NAME: Jesse Gardner
LICENSING EVALUATOR SIGNATURE:	DATE: 02/05/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/05/2026

LIC9099 (FAS) - (06/04)

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Control Number 10-CC-20260202153031

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: CALVARY CHAPEL ACADEMY PRESCHOOL	FACILITY NUMBER: 334818811
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/05/2026

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 02/19/2026 Section Cited CCR 101226(a)	1 2 3 4 5 6 7	Health-Related Services: (a) The licensee shall immediately notify the child's authorized representative if the child becomes ill or sustains an injury more serious than a minor cut or scratch. The licensee shall obtain specific instructions from the authorized representative regarding action to be taken. This requirement was not being met as evidenced by:	1 2 3 4 5 6 7	Licensee stated they will conduct in-service training on the cited regulation and provide proof of such to LPA by POC date.
	8 9 10 11 12 13 14	Based on interviews conducted, C1's authorized representative was not notified immediately after staff learned of C1's injury. This is a potential health and safety risk to children in care.	8 9 10 11 12 13 14
Type B 02/19/2026 Section Cited CCR 101223(a)(2)	1 2 3 4 5 6 7	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, furnishings and equipment to meet his/her needs.This requirement was not being met as evidenced by:	1 2 3 4 5 6 7	Licensee stated they will conduct in-service training on the cited regulation and provide proof of such to LPA by POC date.
	8 9 10 11 12 13 14	Based on interviews conducted, staff did not offer C1 clean clothes after discovering evidence of an injury. This is a potential personal rights risk to children in care.	8 9 10 11 12 13 14

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: Deborah Mullen
LICENSING EVALUATOR NAME: Jesse Gardner
LICENSING EVALUATOR SIGNATURE:	DATE: 02/05/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/05/2026

LIC9099 (FAS) - (06/04)

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