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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 370800634
Report Date: 12/18/2023
Date Signed: 12/18/2023 04:54:10 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MISSION VALLEY, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/25/2023 and conducted by Evaluator Vicky Williamson
PUBLIC
COMPLAINT CONTROL NUMBER: 20-CC-20231025114444
FACILITY NAME:LA MESA UNITED METHODIST CHILDREN'S CENTERFACILITY NUMBER:
370800634
ADMINISTRATOR:AMY FAGANFACILITY TYPE:
850
ADDRESS:4690 PALM AVENUETELEPHONE:
(619) 466-8407
CITY:LA MESASTATE: CAZIP CODE:
91941
CAPACITY:87CENSUS: 34DATE:
12/18/2023
UNANNOUNCEDTIME BEGAN:
03:30 PM
MET WITH:Nancy BetancourtTIME COMPLETED:
04:15 PM
ALLEGATION(S):
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Disaster drills have not been conducted as required.
INVESTIGATION FINDINGS:
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On 12/18/2023 at 3:30 pm, Licensing Program Analyst (LPA) Vicky Williamson conducted an unannounced complaint inspection for the purpose of delivering findings regarding the above allegation. LPA met with Assistant Director,Nancy Betancourt. During the inspection there were 34 children present with six (6) staff members.

During the course of the investigation, interviews were conducted with the director, assistant director, 12 staff members, 11 daycare children and seven (7) daycare parents. Fire drill log and documentation of staff present on date of drills were also reviewed and obtained. Director, Amy Fagan stated that all fire drills are conducted at approximately 10:00 am on Fridays. Staff members interviewed stated that they have not participated in a fire and/or disaster drill as stated on the fire drill/duck and cover log. Children interviewed disclosed that they are not aware of the fire drill procedures. Based on interview and documentation, the preponderance of evidence standard has been met and the allegation that disaster drills have not been conducted as required is therefore SUBSTANTIATED.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Vicky Williamson
LICENSING EVALUATOR SIGNATURE:

DATE: 12/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2023
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 5
Control Number 20-CC-20231025114444
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MISSION VALLEY, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: LA MESA UNITED METHODIST CHILDREN'S CENTER
FACILITY NUMBER: 370800634
VISIT DATE: 12/18/2023
NARRATIVE
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 A Type B deficiency under California Code of Regulations, Title 22, Division 12 & Chapter 1, is being cited on the attached LIC 9099-D.

An exit interview was conducted, and the report was reviewed with Assistant Director, Nancy Betancourt. A copy of this report, along with Appeal Rights (LIC9058), was provided. Notice of Site Visit was given and must remain posted for 30 days. LPA observed notice of site visit posted on the bulletin board in the lobby. inspection. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Vicky Williamson
LICENSING EVALUATOR SIGNATURE:

DATE: 12/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 20-CC-20231025114444
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MISSION VALLEY, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: LA MESA UNITED METHODIST CHILDREN'S CENTER
FACILITY NUMBER: 370800634
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/18/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/12/2024
Section Cited
CCR
101174(d)
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101174 Disaster and Mass Casualty Plan (d) Disaster drills shall be conducted at least every six months.

This requirement is not met as evidence by:

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Asst. Director stated that staff will review the video Disaster Planning and Fire Safety on the CCLD website and submit a summary of the video, staff sign in sheet and a written plan of correction detailing facility's procedures to ensure all children are provided fire/disaster drill training no later than 1/12/24.
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Based on interview and record review, the licensee did not comply with the section cited above as day children interviewed were not aware of the fire/disaster drill procedures at the facility, which poses a potential health, safety, or personal rights risk to persons 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: Tulam Vu
LICENSING EVALUATOR NAME: Vicky Williamson
LICENSING EVALUATOR SIGNATURE:

DATE: 12/18/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2023
LIC9099 (FAS) - (06/04)
Page: 5 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MISSION VALLEY, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/25/2023 and conducted by Evaluator Vicky Williamson
PUBLIC
COMPLAINT CONTROL NUMBER: 20-CC-20231025114444

FACILITY NAME:LA MESA UNITED METHODIST CHILDREN'S CENTERFACILITY NUMBER:
370800634
ADMINISTRATOR:AMY FAGANFACILITY TYPE:
850
ADDRESS:4690 PALM AVENUETELEPHONE:
(619) 466-8407
CITY:LA MESASTATE: CAZIP CODE:
91941
CAPACITY:87CENSUS: 34DATE:
12/18/2023
UNANNOUNCEDTIME BEGAN:
03:30 PM
MET WITH:Nancy BetancourtTIME COMPLETED:
04:15 PM
ALLEGATION(S):
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Staff do not properly clean water pitchers used for children.
INVESTIGATION FINDINGS:
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On 12/18/2023, at 3:30pm, Licensing Program Analyst (LPA) Vicky Williamson conducted an unannounced complaint inspection for the purpose of delivering findings regarding the above allegation. LPA met with Assistant Director, Nancy Betancourt. During the inspection there were 34 children present with six (6) staff members.

During the course of the investigation, interviews were conducted with the director, assistant director, staff members, daycare children and parents. It was alleged that staff do not properly clean water pitchers used for children. Information received indicated that on one occasion a water pitcher was observed with mold on the inside of the lid area of the drinking pitcher. Staff members denied the allegation and stated that the water pitchers are cleaned with soap and water daily. On 10/30/2023 and 11/13/2023 during LPA's inspections at the facility, LPA observed that the water pitchers used for children were clean.









Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Vicky Williamson
LICENSING EVALUATOR SIGNATURE:

DATE: 12/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 20-CC-20231025114444
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MISSION VALLEY, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: LA MESA UNITED METHODIST CHILDREN'S CENTER
FACILITY NUMBER: 370800634
VISIT DATE: 12/18/2023
NARRATIVE
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During interviews with staff members, daycare children and daycare parents, no conclusive evidence regarding this allegation was obtained. There is conflicting evidence obtained during the investigation. Though the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.

No deficiencies cited. A copy of this report along with Appeals Rights were provided. A Notice of Site Visit was provided and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. An exit interview was conducted with Assistant Director, Nancy Betancourt.

SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Vicky Williamson
LICENSING EVALUATOR SIGNATURE:

DATE: 12/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2023
LIC9099 (FAS) - (06/04)
Page: 4 of 5